Dying, But No Faster Than the Rest

I've done it before, but it never seems to get easier: They ask, "How is my [loved one] doing?"

I reply, "How much do you know?... They're dying."

Some of them know it, but can't say it. Some of them get blind-sided. Some of them just cry. None of them react the same, but they all get that look on their face when the light-bulb goes off in their mind. That tears me apart, the moment they see the expiration date on their loved one peaking out from the blanket at the foot of the bed.

I've given up giving false hope, agreeing with the thousand excuses and miraculous scenarios the person asking is hoping I'll tell them. Yes, I believe, but I've seen death more than miracles and the signs are often clear... if you choose to see them. The trick is in how you show them, prepare them, bring them together and help them navigate the inner (and sometimes outer) fights.

They think I'm the expert, not the loved one who's ready to let go and be with their long dead spouse. Sometimes, the patient just knows they can't hold on and is looking for permission from the loved one. In the midst of that, I'm supposed to be the sign post or the weather channel, the portent that signals life or death, the one to tell the family (often) what they already know.

I have to be the first to say it, to make it real or banish all the fears. What's more, the family never wants to ask it in the room or in ear-shot of the patient. They seem to think it's escaped the patient, the one lying in bed. They say things like, "Let's not talk too loud just in case they're listening."

Who? The patient, angels, death?

Even if family never shows up, I know. I mourn. I carry it with me. Each one sticks with me. Each one makes me remember my own mortality and the ones I'll leave behind.

Some nurses get drunk, some get mean, and (worst) some go numb. Personally, I write and always cry, not in front of the family, the lover, the friend, the rest of whoever, but I do cry. I've cried in the stairwell, the break room, the locker room, in bed, or at the solitary bedside of the comatose patient while doing my assessment or hanging medication. I've struggled with God. I've yelled at God in the car before going in the house late at night to go to bed. I've lost faith and gone down dark roads.

But I come back. So far, I've always come back. Sometimes all I can do is put one foot in front of the other until I can look up again, but I look up again. That's what I tell them: the patients and their loved ones. Not all of it, but enough to let them see I care and know a bit of what they feel. Forget the tag you see hanging off the patient's toe or the one you infer on your own toe.

We ask, "Will I ever see this person again, or do I lose them forever? What about my other loved ones? What is the point? What am I doing with my life? When will I die?"

When we're honest with ourselves, we answer, "Yes. We will die. Maybe no faster than the rest, but we are all going to die."

The moments before imminent death, that infinitesimal point in eternal history, make us question life and after. It can rip your psychological well being from its roots. It happens to the patient. I'm sure it's happening to the loved ones I interact with at the hospital. It happens to me, but experience lets me weather the storm with a strong face. At some level, we're all going through the same questions, anxiety, and angst.

What can you do? What can I do?

So far, nothing I can do as a nurse providing care, administering medications, observing what is happening and trying to anticipate what will happen can do anything more than delay the inevitable. Nothing the doctor can do as a physician can stop the end. No amount of family bickering, anger, bargaining, or finger-pointing can affect the past, but we can affect the present.

Discuss what's bothering you, be open, enjoy the moment. Spend now with who you can, when you can. Tell the air if you have to. That's all you can do, but you can miss the opportunity to do it.

Nurses know. Doctor's know. Your loved one who's dying probably knows better than all of us. Do you?