Hektoen International

A Journal of Medical Humanities

They would rather go alone

Kera Morris
Denver, Colorado, USA

 

La Solitude du Christ by French artist
Alphonse Osbert, 1897. Wikimedia Commons/Public Domain

Dad had been in and out of hospice for years. It had not occurred to me that you could go into hospice and come out on your own two feet, but it was apparently the case.

When I got the last call about Dad having an episode and needing to go back to hospice, the resigned looks on the nurses’ faces showed me it would be his last visit. We did not really need to be told.

The nurses liked Dad.

I am not a hospice expert, having only stayed at one for the final week of my father’s life, but it was nice. The wallpaper was suspiciously cheerful, broad bands of light green on dark green. There was a large window looking out onto summertime greenery, and gauzy inner curtains to allow filtered light with thick outer ones to block it. A comfortable couch that pulled out into a bed laid along one wall, opposite a large flat-screen television.

I have spent time in much worse hotel rooms.

Of course, some things reminded me where I was—the floor was tile, rather than carpet. There was the scent of antiseptic creams, and the hospital bed barely filled with a frail man fading in and out of consciousness, guarded by the vital signs monitor that seemed to be there for show more than anything else.

A physician reminded us about Dad’s DNR order.  We saw the doctors occasionally, but the nurses were often by our sides. They taught us to suction his trach and scoot him around the bed to avoid bedsores. They told us to talk to him and play his favorite music. That week ensured I would never listen to Dolly Parton’s Greatest Hits album ever again. Dad has been gone most of my adult life, but “Coat of Many Colors” still wrecks me.

It was important, the nurses said, to let him know we would be okay once he was gone. They told us the kindest things to give the dying were assurances that it was all right to go.

I took to wandering the halls a lot, and the nursing staff was pleased. A few patients in residence, busy with their own dying, did not have much in the way of family and friends. My father had siblings, in-laws, friends, and daughters so I thought he would not mind sparing someone from time to time. I brought flowers to the lady down the hall, who showed a nurse and me photos of her family.

I wondered where they were.

An infant patient had her own room but spent most of her time at the nurses’ station. She looked like any other baby, being bundled up and passed around. She would coo and grip your fingers, grin in that charming, toothless way. On one of my runs for snacks, flowers, and reading material, I picked up a dress and a plush toy for her. The nurses were delighted and the next day one of them dressed her up. “Her parents don’t come visit,” she confided. “I take her to church services.”

While a group of us stood around babbling nonsense with the little one, a visitor wandered by. “You’re going to ruin that baby,” he smiled as he passed us. “Don’t let her grow up spoiled!” We had clearly painted a picture of a very different situation—of someone visiting with a perfectly healthy baby. A nurse on maternity leave, perhaps, was visiting to show off her little one to coworkers. Our good cheer was gone suddenly, blown away by the mild breeze of a passerby. We would not spoil the baby; she would not grow up at all.

The presence of death is a game changer. On my first day at hospice, I noted with trepidation that one of the girls who used to bully me in school was now one of Dad’s nurses. She had grown into an empathetic, soft-spoken caregiver. I watched her bathe my father with gentleness, crack jokes with him when he was awake. I took smoke breaks with her in the smoking-room. We laughed about the existence of such a thing; patients still capable of sitting upright and holding their own cigarettes could smoke in the comfort of an air-conditioned lounge. I joked that we were preparing ourselves to be the next batch of patients and she cawed, jetting smoke through her nostrils.

Her ritual—and that of every smoker nurse—on leaving the smoking room was not unlike scrubbing in for surgery, though it seemed less necessary somehow.

I doubted she remembered me from high school, and I did not say anything. It seemed better that way.

Dad entered hospice as an alcoholic. He had been an alcoholic for many years already, but alcohol withdrawal when you are already dying seems extraordinarily unfair. We snuck a bottle of whiskey into his room, troubled. How on earth would we get around this?

A sharp-eyed nurse noticed before we got too far in our worrying. Smiling, she shrugged and poured our whiskey into a little plastic cup and sucked it up into the plastic syringe she pulled out of her pocket with a magician’s sleight of hand. Handing it over to my sister, she supervised the pushing of Old Crow drip by drip into Dad’s mouth. He nursed it with clear gratitude. “Just not too much,” she said without a lot of conviction.

None of the nurses, it turned out, would be bothered by us feeding Dad shots. One commented that keeping the shakes at bay was a blessing. I wondered what the doctor would think; water was one thing, but here we were with syringes full of well-whiskey—all any of us could afford. He was not receiving nutrients. We were literally, per his orders, letting him starve to death.

Of the hundred things big and small the nurses did for us and for Dad that week, running interference ranks highest. His siblings were angry that we were letting him starve to death and would not hear a word of ours; the nurses were certainly not going to allow them to belittle or berate us. Each said, at some time, in some way: patient care comes first, and that means the patient’s wishes come first.

The night before Dad died, my sister and I stayed up later than usual. Maybe in some reptilian-brain way, we knew. We got drunk and reminisced bedside, cleaning Dad’s trach whenever his breathing crackled, toasting the nurses coming and going as the night wore on. His blood pressure became normal—it had been low all week. The numbers glowing a totally typical 100/70 or so, plus the whiskey, inspired in my sister a last-ditch kind of optimism.

“That’s good, isn’t it? His blood pressure is great!”

The nurse hesitated only a second before shaking her head a little, murmuring that this just happens sometimes. She wrote down Dad’s vitals and patted his hand, asked how we were doing. We’re fine, we said, sipping our drinks. We watched television, grew tired. Weary. Around 3 am, we slept.

The next thing I knew, a hand on my shoulder woke me. “I’m sorry,” said the nurse. “He’s just passed.”

While we struggled up and back to Dad’s bedside, and held his still warm hands, my sister asked the nurse why she had not woken us up.

She told us that the dying often prefer to go alone, not while being watched. She said that he had been listening to us telling him it was all right to go, and that we would be okay. That some part of him had noticed, even in his semi-conscious daze, when we fell asleep, and he could let go. It’s less distressing that way, she told us, and the dying know it.

I kissed my father’s hand and sat with him to wait until they sent us away. When the dead are gathered up, the family is not permitted to watch; the machinery of death is too clinical not to hurt.

When we said goodbye, the nurses with us teared up, too. I wondered at their compassion and empathy, and how they did this every day. They made up a small card, a farewell to set on a table by their station. Every patient who dies gets one, and they are cleared off from time to time. I wonder if that hurts, too.

All I could think to say was to thank them all, for taking care of my father. It was a gift I did not anticipate or expect. One of our nurses responded: “It was our honor.”

I believe it was more mine.

 


 

 

KERA MORRIS holds a BSc in Psychology from the University of Auckland, New Zealand. She currently resides in Denver, Colorado and is interested in science, literature, and satire. As a relatively new journalist and freelancer for Westword as well as editor-in-chief at her college paper The Arapahoe Pinnacle she has found that there is no limit on how much information you can dig up on any topic and has become a bottomless resource of banal minutiae. As the fiction editor of the 2018 Progenitor Art & Literary Journal she has rediscovered that she does not really get poetry but appreciates it.

 

Winter 2019  |  Sections  |  End of Life

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