University of Illinois, Chicago, United States
Springtime has come to the desert. It is subtle, but spring, nonetheless. I am here with a group of nursing students who are spending their break working with a humanitarian aid organization serving the undocumented border crossers. Some of us are in Nogales, which spans the Arizona/Mexican border, some in the desert camps. The name of the organization is No More Deaths.
Since 1994, hundreds of individuals have perished each year while trying to cross between Mexico and Arizona. We know the actual number is much higher because many simply disappear, offering no traces to be counted and catalogued. So volunteers leave water strategically placed in the vast Sonoran wasteland, go on hikes and in jeeps with first-aid kits in hand, or assist and feed those who are "detained." But end the deaths? Hardly.
Most nursing students know by the end of their first semester that death is beyond our power to resist. We can stave it off, placate it, delay its appearance, but we cannot tell it, “no more—be gone!” We come to this knowledge in ways largely experiential—the loss of a grandparent, friend, patient, or parent. It is not often discussed in classrooms or on clinical units. Instead, we learn the medications and interventions to hold death at bay, and when it intrudes anyway, we feel largely defeated, somehow to blame. We don't know exactly what to say, and so we say nothing. Even when the loss is our own.
My mother died when I was 21, the age of many undergraduate nursing students. Her death came in the mid-70s, in a time we like to believe was less enlightened. She died quickly and rather horrifically of pancreatic cancer. After her death, I shuddered and vowed that I would have nothing to do with the brutal field of health care. A little less than two decades later, my father lay dying—a tethered, technological death on the unit where I practiced as an oncology nurse. I traveled to England after his death to learn about nationalized medicine and hospice care and to reconsider my chosen occupation. I also wrote around, through, about, and between their deaths. I continue to do so and will probably not cease till my own end is upon me. Some complexities require confronting the visages and sensations etched in the body and picking up the pen again and again, lest the bones become buried without proper commemoration.
I now practice as a hospice nurse, an area in which dialogue around death is commonplace, encouraged, and facilitated across disciplines and gatherings of loved ones. In my role as a faculty member at the College of Nursing at University of Illinois at Chicago, I attempt to offer a Death and Dying elective each year. Sometimes it is difficult to do so as the required courses encroach upon the scarce time of students. But I try, nonetheless. It is important to have a forum in which to invite discussion of death before we go forth into the desert to confront it.
Last fall 22 students participated in the elective. We read memoirs that dealt with the death of a generation—Paul Monette's Borrowed Time, works that considered how to help to prepare children for loss—The Goldfish Went on Vacation by Patty Dann, and treatises on the departure of faith and encroachment of madness often associated with profound loss—Lewis’ A Grief Observed and Didion's Year of Magical Thinking. We considered the physiological stages that accompany death, and we examined our own responses from when it intruded upon our homes. What follows are the recollections and reflections of two students who experienced the loss of a parent under strikingly different circumstances. The class format encouraged them to revisit these painful experiences, to view them from the lens of childhood, and to reconsider them from the perspective of one soon to enter the world of professional nursing, an arena in which death cannot be avoided, only embraced.
In sharing their essays, Erin and Kristen allow us access into that vulnerable world in which childhood innocence shatters and our hearts crack a bit with hard won compassion. Until we find the ultimate cure for mortality, this is the balm we offer one another: to speak of loss and its attendant memories, to acknowledge the starkness while we search for signs of regeneration.
Even in times of despair, spring returns to the desert.
GERALDINE GORMAN, RN, PhD is an assistant professor in the College of Nursing at the University of Illinois at Chicago. She also practices with Midwest Hospice and Palliative Care Center. She is a member of the Hektoen Institute’s “Nurses and the Humanities” program series advisory board.