It’s a Friday afternoon, the clock is nearing 4:00 pm. My workday will soon be over. I receive a call from the office. A new admission and the afterhours nurses already are busy with patients to see and needs to attend to. Yes, I will go. Internally rolling my eyes and muttering unpleasantries under my breath, I sit in the drudge of rush hour traffic, crawling my way to your home.
I knock at the door, my back is aching and I am pulling my nursing bag behind me. I am greeted by your frantic husband. A wearied caregiver, his eyes are desperate and his voice cracks as he opens the door. Behind him, your daughter, I can’t imagine that she is much older than my own kindergartner at home. Through whispers and short conversations meant to keep adult subjects away from little ears, I learn you also have a son with special needs and little time left on this earth to mother your babies.
I am ushered back to a small room at the end of a dark hallway. I can imagine this home was once happy, was once warm, filled with smiles and giggles and carefree family moments. I imagine the smell of chocolate chip cookies and sunshine as you greet your children from their days at school. But those must be distant remnants of what was, because now it is dark and too warm for the season. The air is heavy and wrought with uncertainty and stress. The hallway smells stale and is eerily quiet save the buzzing from the oxygen concentrator in the corner of your room.
I glance at you. You are in pain. The muscles up and down your chest heaving inward with each sharp breath you inhale, yet you manage a smile at me. You have beautiful blue eyes that haven’t yet lost their twinkle. Even after chemo and surgery and radiation, your eyes still have a spark. Your head is covered in the baby fuzz of new hair trying to grow in, a sign of life in a body so far from it. A blue hat hugs your skull loosely and falls down in the back. Your faded nightgown seems five sizes too big and I wonder what you may have looked like before this terrible disease took its toll. I glance around the room for photos. I key in on one of you on your wedding day. You are wearing a delicate white dress and a smile from ear to ear. A life ahead of you is full of potential and happiness. But today you are too exhausted to speak. Too exhausted to eat. Yet you fight, every deep breath you take is an audible reminder of your struggle.
I ask you questions, but you cannot answer. Your husband speaks for you. He recites the epistle that is your medical history, going through the long list of treatments and trials and symptoms. The successes and failures that now more resemble a grocery list than a life lived and a battle fought. He tells me about your pain, about your unwillingness to take pain medications as you feel they might take away from the lucid moments you have left with your loved ones. Mother to mother, I understand. Human to human, I see the pain you wear all over your frail body and I can’t help but want to do all I can to help take it away.
I go about my work, quickly assessing your physical condition. Warming my cool stethoscope in my hand before I place it on your bony chest. I listen to your beating heart that sounds a million miles away and briefly think to myself how few beats it must have left in it. I listen to your belly, seemingly quiet for a vessel that has been empty for days. I examine your skin. It is dry and non-elastic, bearing the marks of dehydration and side effects from various medications. I save your lungs for last, fearing that even listening might add to your burden. I say a little prayer the rattling, noisy breathing so common at end of life skips you over, not really for your sake, but for the sake of the little girl running around your bed sensing that something isn’t quite right, but not fully understanding what it is.
I speak again to your husband, your surrogate voice, and explain options for medications, tips to alleviate symptoms as much as can be alleviated. And he asks what they all seem to ask at some point or another, how long? How long does my beloved bride have left to be at my side? I have no crystal ball, I do not claim to know much of anything, but my best guess is days to weeks. And it never gets any easier, telling folks that those they love don’t have much time left, and the time they have is growing shorter with every grueling breath they take. And now I wonder if I am being any help at all or just sucking up some of your precious time together with small talk.
I provide your partner with a little bit more information that is routine to me but seems to bring a small comfort. I will visit again soon, but that is enough for today. I have absorbed all of your emotion. The happiness, the sadness, the anxiety, the fear. Not a fear of pain or dying, but the fear of leaving your children without a mother. That fear was palpable, even on top of all the other terrible symptoms. I wish I could do something to make it easier. But there is nothing to say or do, nothing to do but to go home, to not complain about sitting in traffic and to be grateful of the hugs that await me at the door from my own children. To be grateful that today, I am alive.