It was one of those nightmare weekends that made me wish I'd never left the deathless, bloodless world of computer engineering. A patient I'd grown attached to was dying from lung cancer, and every time I'd go in his room to check him, he'd pull down the 100% rebreather and gasp, "Is she here yet?"
The "she" in question was his daughter. And, no, she was not coming. You never know what a person's past is, or the darkness that might have shadowed a relationship, but the daughter had been adamant that she was not coming and not to call her again. He had no other family. In days when he'd been better, we'd joked and tried to pretend this was just going to be one more hospital stay out of many. But this stay was different, and we both knew it. The first day I had him while he was still on 6 liters, he took my hand and told me, "I want you to know how much I appreciate everything you've done for this old man. I'll pray for you from the other side." I'd seen the radiology, and I just took his hand and held it, and choked back my tears. Now his head was thrown back, and his mouth in an "O" as he tried to get oxygen into lungs that weren't able to do anything with it. I listened to lungs so diminished and full of crackles I knew it wouldn't be long. He opened his eyes and looked at me, too weak to speak. "Mr. Smith, she's not here yet."
Two hours later, the inevitable happened, and he died. I gently washed his last stool from him, and slipped the catheter out while other nurses removed IV sites, the mask, the SCDs, and other signs of our work until he was once again free of us. We combed his hair back, placed his dentures and propped towels under his chin. I looked at him, and saw how my dad might look on that day, the same big ears, the same Karl Malden-ish nose. I had called the daughter, this time to tell her he had passed away, and she said, "What's that to me?" and she had slammed the phone down. My gentleman would spend the night in the morgue, and then be sent to county. Whether he would be given a decent burial attended by friends, or wait his year unclaimed before being given a pauper's funeral, I didn't know. I tied the tags to his toe, and to the outside of the bag, and the third to his tiny bag of belongings, which we inventoried. There was a pair of shoes, a pair of pants, a t-shirt and flannel shirt, a worn belt and a brown overstuffed wallet. "What's this doing here, it should have been locked up," said the charge nurse, who opened it. Inside was a driver's license, AARP card, all the little clutter that accumulates in a wallet, but then she stopped and said, "oh...."
Pictures. There were at least 2 dozen. The firsts were of the patient as a young 20 something, in military uniform, an arm around a young woman, both holding a baby. The baby grew from an infant to a chubby toddler, racing around the yard, then playing with a hoola hoop. One she was about 10, running on the beach, blonde hair flying like a flag. One looked like Christmas morning, another perhaps at a farm or petting zoo, with a donkey eating out of her hand. Then the pictures stopped. There was a newspaper clipping of her high school graduation, another of the daughter's wedding. The mom's name was mentioned, my gentleman's was not. There was a birth announcement for two grandchildren I knew he had never held, also from the paper. The pain and the longing for what could have been washed out of the wallet like a wave, and one of the nurses, pregnant with her first child, burst into tears and fled the room. I reached over and took the picture of my patient swinging his daughter high into the air, both young and happy, and slipped it into his hand, where I secured it with a piece of tape. "She's here, Mr. Smith. She's here." We sent him on that way, holding the picture of his child.
Desperately sad, I had barely gotten back from the morgue when my new admission arrived. He was an elderly black man, skin leathery and thick from years of working on the farm, and he was blind. I began my admission questionnaire, explaining my sniffing as allergies, sure that in his blindness my patient would buy my excuse. I listened to his lungs and his chest, thankful that his BP had come down and that he would likely go home in the morning. He spoke of his years farming, split with time in the pulpit. "And didn't I pick the two things you can't do once your eyes fail you? You can't tell if a crop's ready, or sickly, or needs fertilizer if you can't see it, and how do you proclaim the Word if you can't read it?" I was quickly doing my assessment, and desperate to get off the floor, find a quiet corner, and have a nervous breakdown.
Suddenly, he stopped. "Child, give me your hand." I did, puzzled, and he turned his filmed over eyes directly at me. "What ails you?"
That's all it took. I sat down on the edge of his bed and, feeling like a complete failure as a nurse for weeping, I began to weep. Weep for my dead patient, and the child he still loved. For the daughter who had gone most of her life fatherless, for the grandchildren he was obviously so proud of, yet never held. For the lady down the hall, who thought she was going home, but was going to a nursing home instead. For the teenager who'd tried to commit suicide the prior day, and was now in the twilight land of hypoxic brain injury, never to return. For the stroke victim 2 doors down who was locked in - hideously aware, and unable to do more than blink. I wept for all the countless small sorrows and large tragedies that we see and that we can't help, can't fix. Over me, the blind man had dropped his other hand on my head and was praying in the deep, sure and true way of those who have walked this world for decades, solid in faith. He spoke of power and grace and love, and that one of the truest works of mercy is that of caring enough for a stranger to cry for them.
The lesson the blind man taught me was that we are all human. We are not nurses; we are women and men, moms and dads, daughters and sons - we are human beings doing work that can wound and maim our souls. And somehow, we are taught that the very humanity that brought us to nursing should be strangled and beat down and hidden away like it is something shameful. It is battered and bruised by the things we see, and we grow calluses over the softest spots so that we aren't in constant pain. But blind man saw the truth, and I bless him everyday. The day I can't care enough to cry for a stranger is the day I need to go do something else.
Last edit by Joe V on Aug 12, '09