Beginnings and Endings

End Game RN, RN

Through the glazed windows of my soul I watch as the scene played out before my eyes. I stood quietly observing the final hours of my patient and her family.

Shadows danced on the walls in the room where she lay. Sunlight filtering in through the grated window brought into focus the few scattered orange freckles sprinkled across her nose. Crystalline tears dotted her cheeks. Her pale grey face glowed with the promise of another day, in another time and space, outside the drab existence of those of us who remain.

Colorful wooly animals were packed on a shelf nearby, their warm comfort more for the family and friends standing vigil; waiting for something they will not openly express; perhaps fearing that somehow the words spoken aloud would be the final truth.

Now exhausted, her parents sitting in chairs positioned close to the bed on either side of their daughter, rest their heads on the still soft form of this woman child, inanimate and heavy in physical death, wearing the accouterments of the true church. Scapular placed around her shoulders and head by the faithful. Wrists entwined with Rosary beads and bracelets. In a moment of whimsy a package of her favorite pop-rocks were placed alongside the religious articles. Two stuffed animals were tucked neatly in the crook of her left arm appearing as if the girl was holding them.

Some of those present beg for a miracle, challenging their G-d to intercede. They become insistent and demanding in their prayers, unanswered by a seemingly uncaring deity. Some cannot understand that G-d does as he pleases.You may ask but cannot compel G-d to do your bidding. His decisions are not that of a capricious child but part of a greater plan outside our scope of understanding.

I witness this with two nurse acolytes who stand with me quietly observing this scene. This experience foreign to them, sharing this private moment, grieving with the family, seemingly embarrassed when I see the unshed tears in their eyes, choking back soft, near silent cries in sympathy as the scene continues to unfold. I position myself between these nurse interns, speaking quietly to them as we stand as silent witnesses, watching as dozens of lives are forever altered, some destroyed by this tragedy, knowing that nothing will change what happened to this girl and her sister one early morning in a split second; a series of poor choices forever altering the lives of another family, the friends and colleagues of the deceased in the other car; struck down in a foolish moment, just blocks away from his home.

I explain to these young women their responsibility when caring for both the patient and the extended family when death is expected. I explain how to be a silent yet comforting presence, gently touching the closest family member, turning off the alarms on the eerily glowing monitor as vital signs fade; encouraging the grieving to gather around the bed, sitting or standing, touching the patient or her bed, being sure that each person who wants to do so can.

I encourage those strong enough to talk about this girl to share the humorous stories of her short life, acknowledging her uniqueness by speaking aloud how she impacted her lives.

Her father bragged about her skills as a fisherman, catching a large parrotfish in a canal that should never have had any fish in it. How she learned to bait her own hook, bragging about her ability to cast her line far out into the water; first demonstrating this skill at a very young age; enjoying this time with her father. He told us how he would clean her catch and cook it for her.

There were photos of her dressed for a formal with her sister and her friends and a photo of her getting a kiss from a horse. He stretched his head and neck far out over the stall door, she was leaning in to allow him to kiss here. There were other photos as well, numerous cards and letters from her school friends and family.

Her father had been playing a song for his daughter repeatedly over the last few days of her life. He explained to anyone who would listen that his daughter had told him this was their special song. He said that they had danced together to this music. Father and Daughter. Now realizing that this would be their final dance.

I recognized the song, it was Butterfly Kisses, he held her face with both hands sprinkling her with dozens of gentle tiny kisses, unmindful of the endotracheal tube, gastric tube and the soft rhythmic sounds of the ventilator. He cried while sharing with us how special she was and how his life was complete for having had her for such a short time. Her mother clung to her child, sobbing her grief, unable to speak. Grandparents, uncles, aunts, cousins and other extended family members and a few friends from school stood as sentinels in her room surrounding the parents with love and sharing their pain.

There was soft laughter with occasional humorous outbursts from some of those who sat by the bed relating their own experiences with this girl. There were those sobbing intermittently while listening to the others, unable or unwilling to understand that this sharing was also a part of the grieving process. The cadence of their crying and wailing rising then fading echoed in this small room, spilling out into the hallway as unbearable grief was expressed.

Time passes. To swiftly for some, too slowly for those who have stood vigil since the first day. Minutes later, just before noon, she is finally freed from her mortal self. More family and friends arrive to comfort the two sets of parents who claim this girl as their own. The "first" Thanksgiving, Christmas and New Years without this daughter will weigh heavily on the family.

Soon the family leaves. One of the nurse interns remains with me learning the care of the deceased patient; preparing her for her next journey to the medical examiners office, the funeral home, her final resting place yet to be determined by her family.

I explain everything to this new nurse as we perform post mortem care. As required by law all lines and tubes remain in place awaiting removal after the medical examiner finishes with her. A young man arrives with a stretcher. There is an orange backboard and a neatly folded purple velvet cover lying on it. We assist this young man as he pulls her onto the stretcher. He positions her gently, carefully before unfolding the purple velvet cover, symbolic in its resemblance to the receiving blanket of a newborn. As he covered her he showed both compassion and respect for this young girl.

Beginnings and Endings are an integral part of our lives as we march forward. There is the beginning of the journey to be traveled by these young nurses' as they continue to grow in wisdom and compassion; practicing and perfecting their art and newfound skills, never forgetting a father's Butterfly Kisses in a room of dancing shadows on a clear November morning.

And the ending of a young life never fully realized yet loved beyond measure.

Eeka End Game RN

This is for Valerie and Jillian, two nurse interns who were my inspiration for sharing our story.

This is also for this child's family, extended family and friends and her school who provided so much love and support. It was an honor and privilege to care for you.

Beginnings and Endings

About End Game RN, RN

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