Mourning with those......

This is an experience that I had a few days ago that I would like to share. It is personal and isn't like my usual post. In my job I usually get the opportunity to help people get better, but somedays I get the opportunity to help people advance form this life to the next. This is about such an experience.

I got an opportunity to be apart of a woman’s passing. I was the nurse of Jane Doe. An obese woman who ended up dying from her weight and all the complications that arise from it. She was morbidly obese. I took care of her for the first time 4 days prior to her death and she looked bad then. She was on dialysis every day and was so sick she was unable to tolerate even a gentle wean from the ventilator. She was so swollen that even her upper ears were puffy - that is hard to do. Despite dialysis, on the day she died, you couldn’t even pry open her eyelid to check her pupils, she was so fluid overladed and swollen. If you did get her eye lids apart her whites of the eyes were so puffy that it filled the void instantly making it impossible to see the pupil. It took 5 people to turn and clean her up. How long could this go on? Without intervention perhaps days, maybe even a week or two or more. Modern medicine is amazing at what it can keep alive.

That day her husband walked in with resolution in his voice, “She can’t go on anymore like this. We should stop.” This patient had been in the hospital since January. Relief filled me at these words. Before he came in I was ethically challenged every time I walked in that room. It was hard to see a person like that and it felt so futile. I talked with the husband verifying if the timing of today would be best for him, the patient and their family. He sobbed as he told me yes. After the orders were in place he vacillated back and forth about wether this was the right thing to do. Every person (medical staff, family and friends) reaffirmed him, and this was helpful to him in proceeding but not in completely dissipating the fear. He had so much guilt for the state she was in. These are not good emotions to feel. I hurt for him that he not only has to suffer the sadness and unwanted change that comes from the loss of a loved one, but to battle guilt and doubt as well, will be a difficult path for him. One downside of our advance medicine is that we can be put in positions where we think we are killing our loved ones when withdrawing medical care. Without proper understanding that is exactly what it looks or feels like. However when one understands the human body and what our medicine is really doing we learn that keeping a body pink and warm and a heart pumping, is not always a real “life”. Living is not merely defined by the temperature of your flesh. Our advance medicine does not make ethical decisions - the people who use it must be the ones to make those decisions, and it can be so hard - especially without knowledge prior to such events.

We began the weaning process at 11:30am. I turned off all the meds including the blood pressure medication that was keeping her blood pressure perfusing all her organs and increased her pain and sedation meds. The respiratory therapist (RT) began a slow wean from lots of breathing support to letting her breath on her own. Right before we began the husband noticed my CTR ring. “Are you mormon?” he asked. Come to find out the family was LDS from a local stake. In an instant I knew so much more about this family and they knew so much more about me. We started saying words like relief society, home teachers, priesthood blessings and it immediately advanced our connection. I was not only his wife's nurse, but also a believer in God, the priesthood, and that families are forever. Death is so very much spiritual. If you are religious you believe you leave your physical body and go into a spiritual world. You, your life and your relationships continue.

His wife death was a very hard one as it would be for any husband. He was a talker and quick to show emotion and so everyone knew just how hard it was for him. This didn’t bother me as I much prefer to deal with an emotional person then an emotionless person. Plus it makes total sense why one would be sobbing on this day to me. His son was with him but his other children were coming from other states. He bust into sobs off and on and I couldn’t help but shed a few tears myself. Mourning with this family cam easily to me. In such situations I often find myself fighting back tears. Ever since I had kids, if someone is crying, I want to cry with them. Is crying unprofessional? Will it be of comfort or make it worse for the family? Today none of those questions came to mind and I just wanted to share love with these strangers. On one particularly emotional breakdown of the husband’s, I wanted to offer to say a prayer with him - after all we were of the same religion and prayer is just what you need in such a situation. But I have never offered prayer with anyone at work let alone a patients family - who I just meet 1 hour ago. I started to walk away talking myself out of it but quickly told myself to not be a weeny and turned myself back around. At first the husband refused but the son quickly and affirmably said, “yes”. Then the husband admitted, “I don’t think I can say it.” I happily offered to give it and we all knelt in prayer. As long as I am allowed to cry, I am super good at giving sincere prayers. It was awesome and not at all uncomfortable. We were now friends forever. Unified through a trial and love. As luck would have it she became my only patient and so I spent most my time in that room, talking with the husband, reminiscing of their life together and increasing sedation and pain meds for proper effect. She was very comfortable. 4 hrs later, RT finished weaning her off the ventilator and placed her on room air - breathing on her own. Weak from her illness and diseased lungs, once the oxygen was turned off, she quickly started declining and the father and son said their final good byes.

It all reminded me of my own fathers death. The spirit I felt in that room was the same spirit I felt in my fathers hospital room. Love is so calming. I am sure that husband will have a lot of struggle as he transitions from a full time caregiver of his favorite person and partner for 45 years to that of a single man in search of a new role. But I know that like with all difficult trials, if he can but quiet himself, or make himself still enough, he will know that there is a God, feel of his presence and love and make that transition in time to a place as happy if not more happy then any other time in his life. I bear witness that there is a God and he knows and loves each and everyone of us - and there is great power in that.