Some hospital realities have a pointed way of needling my nerves. The relentless beeping of medication pumps calling for a nurse permeates like tinnitus. That ringing in my ear is why I initially looked in on this particular patient, a woman in the burn unit’s hospice. The first thing I noticed when I entered the patient’s room was a little blue box floating on the black background of the television, which played soft classical music.
Like the blue box on the TV, I was “floating.” That is what we call it in nursing when supervisors pull you from your usual unit to some other understaffed part of the hospital. There were not enough infants in the neonatal intensive care unit, where I ordinarily worked, to justify keeping me there. So I floated, this time to the burn intensive care unit where nurses were drowning.
I couldn’t tell if the patient facing the music could hear it. Maybe, like the rest of us, she was insensible to death’s immanence. After nursing school, I expected numbness or some other form of psychological coping to liberate me from the gravity of existential crises. And if not after nursing school, I had hoped my Catholic religious life as a Jesuit, with an attentive eye toward the afterlife, would be sufficiently mortifying. Yet, some hospital shifts resurrect realities my subconsciousness has managed to bury.
For instance, the creepiness of seeing the morgue remains quite the undertaking. The ancient aphorism memento mori, “remember death,” is evergreen in health care despite our efforts to forget it emotionally or thwart it medically. The maxim proved a new sort of disturbing when I looked in on this woman, a living reminder of life’s brevity.
Her cardiac rhythm attested she was alive, but her appearance made it seem impossible. I could see parts of her skull. Her nose was gone, and her lips swollen shut the way you might imagine eyes to be after a fatal beesting. I stood stunned by flashbacks of childhood memories covering my eyes while watching the gory blockbuster film “The Mummy.” As a child, it was easy to turn away from vulgarity. It was just a movie. But in this patient’s presence, I was struck by fright and frozen without a fight or flight response. I couldn’t take my eyes off her. The pump kept ringing, and the music from the TV kept playing.
Eventually, resolve overtook awe. I fixed the pump and returned to the safer nursing station. I asked the nurse assigned to this patient how long she thought this woman would live. The response was evasive. She told me the woman had been fighting death for two days. Two days or a lifetime? Before I took lunch, I asked the staff to call me if her status changed.
Something did change. Upon returning, the assigned nurse asked the doctor, “Do you want to call the family?” The nurse said it looked like death would be within the next hour, and then she took a few steps before more lights started blinking. “Never mind, I think she is going too soon.” The nurse donned a protective gown to respond to the beeping of yet another one of her alarming patients. While the dying woman’s nurse was preoccupied, I stood at the threshold of the room the woman’s family would not reach, and I watched her turbulent heart rate waver on the monitor hanging above her agony: 114, 97, 120, 95.
I knew too little about this middle-aged woman to guess about her life or readiness for the next. I did know that the cause of her lethal burns was senseless violence. She had been the victim of a Molotov cocktail thrown through a window of her home. I knew the blood we cleaned from her carried H.I.V. I knew it was difficult to control her comfort with pharmaceuticals due to a tolerance developed by her drug addiction. The inconsistent medication pump was not doing her any favors. But these details don’t define a life. She remained a stranger.
As unnerving as it is to be afforded such trust by a stranger, maybe if she were conscious, she would privilege me with her life story. I wish she could have had the chance to tell me about herself. Would she have given me eyes like God’s to see her for who she was? Or, would she have judged me too judgy? Might the woman hide behind her life’s lies to no end, as some patients do, like Adam in Genesis? Would bareness be unbearable? She owed me no explanation of her life, but isolation, or the isolation precautions, seemed insufferable.
In any event, the only part of her story we shared was this penultimate moment. And as false hope began to think her family might make it in time, her heart rate committed to a gliding descent: 76, 74, 58, 46. I put on the plastic gown and gloves required to cross the threshold of her room. I held her bandaged hand. The discomfort was mutual, the struggle substantial. It was also short-lived. The monitor read zero.
I anticipated greater diminuendo after death’s crescendo, but instead, the room rested. There was brief peace between sudden stillness and when I felt a presence leave. Even the medication pump remained silent. If you have ever had the distinct privilege of being there when a soul leaves the body, you know it is a truth you cannot see and also one too palpable not to believe.
I gave the doctor a nod as I returned to my duties, and I wondered what new phase of mortal fear nursing was trying to teach me. After answering other ringing medication pumps, I drove home on the interstate that evening. I clocked out of my twelve-hour shift and tuned into my interior shift. I am sure trauma experts have better analogies, but the dismantling experience gave me an appreciation for the power of plate tectonics to cause continental drifts. I was taking work home with me.
I did a prayer exercise that Jesuits call the Examen, conjuring images from my day to see how God was at play. Cars were passing me by as I downshifted. Revisiting “The Mummy” and the maxim memento mori in too clear memory, called after by whispering voices of virtues and vices that charioteer my own end, I concluded conversion isn’t only for those on their deathbed. A winning line from a different blockbuster, a twinning Latin aphorism, teased me in the 1989 voice of Robin Williams’ “Dead Poets Society.” Carpe Diem.
Photo courtesy of Mike Bird.
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