Death has always been like an unwelcomed guest in my life. At the tender age of three, I lost my grandfather to complications from a stroke. Within that same year, I lost my great grandmothers. I’ve experienced death many times, but it was the loss of my step grandfather, Paul, that influenced my decision to volunteer at Hospice. I thought I was prepared for anything, but I’d only scratched the surface. It only took one day, one shift out in the field to realize just how much I didn’t know about this mystery we call death.
On Wednesday, February 9, 2011, I was scheduled to sit with an older lady from 12:45 to 3:45 P.M. who had been diagnosed with COPD, a consequence of years spent smoking cigarettes, a habit that she still couldn’t conquer even after her terminal disease made breathing incredibly difficult. In fact, during a prior visit, she said to me, “If I’m going to die, I might as well enjoy the time I have left.” On this particular day, I arrived at around 12: 30 P.M. I walked into the house from the garage door, through the kitchen and into the living room where she lay unconscious on her bed by the window.
I was taken aback by the state she was in. Her every breath was a desperate gasp for air followed by long, horrifying periods of apnea. Gurgling noises came from the collection of throat secretions in the back of her throat. The death rattle, I thought to myself. She moaned several times. Her vitals were taken and it was determined that transport was needed to take her to the hospice unit at the hospital. I stood in shock, but my emotions were bluntly interrupted. I needed to notify my supervisor. “Stay with her until they transport her. There’s no need for you to go to the hospital,” she told me.
Back into the room where my patient lay dying, the nurse stood beside her, holding her wrist. “Her pulse is 122. That probably won’t come down again. Her lungs aren’t working right, so her heart has to work harder, but she can only sustain this for so long,” the nurse explained.
My patient’s husband walked in from getting a breath of fresh air. At the sight of his wife’s deteriorating condition, he sighed in defeat. Suddenly, her eyelids opened; her glassy eyes were rolled back. We knew it was time to say goodbye. The nurse gave her a combination of Roxanol and Ativan and then the room became quiet as our patient became calmer and this faded into a few moments of absolute silence.
The nurse checked for a heartbeat. “2:15 P.M.” The nurse called out. The words were so final and that was a moment that will forever be etched into my mind.
“She’s gone?” The husband asked, sounding truly broken.
It was the demise of my patient that taught me how to cope with the ghastly rawness of death. This experience, one of the most profound of my life, allowed me a greater understanding of the blurry line between life and death. Minutes after she passed, I touched her hand, feeling the smooth, cool texture of her skin. Blotches of purple and blue covered her arms, her nails were completely gray. I looked to her once beautiful face and her mouth locked into one position. Her eyes, though slightly open, were vacant. The essence of my patient, her spirit, disappeared. What remained was a body containing its many systems of organs, or “parts”.
Death is eternal, life’s final chapter, but I still believe in the possibility that somewhere her spirit remains alive.