Dying with Grace

Today was not really a good day at work. Or maybe it was.

We were pretty busy when I came in at noon - they were resuscitating someone in room 4, room 2 was a motorcycle trauma, room 3 had been choppered in from the boonies for continuous seizures and I had to go up to triage to tell 17 people that there was still no room in the inn. By 3:00 or so we had finally gotten caught up to the point where we could at least breathe.

And then I got my little old man in room 8. Not really old in the grand scheme of things, though - only 65. He was brought from a nursing home for difficulty breathing. My friend on the ambulance actually responded to the call and did a great job of treating him enroute. He was only able to whisper, but he knew where he was and what day it was. He said he wasn't in pain. I put him on the monitor, drew some blood and did my assessment. The poor man sounded like his lungs were full of water. It was so bad that I couldn't even hear his heart beating over the sounds of his breathing. And I couldn't feel a pulse anywhere - hands, feet, neck. But he was still awake.

Our ER physician called the man's primary care doctor, who made it to the hospital in about 20 minutes. I love this doctor - so caring, mindful of patient's wishes and a genuinly kind man. He stayed in the room with the patient and me for the next half an hour while he quietly passed away.

The man kept squeezing my hand. Strongly at first, then with less and less pressure as his breathing became the focus of his remaining energy. His rhythm slowly decreased on the monitor and his breathing became more shallow. He no longer answered when we called his name.

A friend of his came to wish him goodbye, as this man's children lived out of state and across the country. The doctor contacted his sons and prepared them for the immenent. We put the phone to the dying man's ear and let his children say goodbye. And then there was silence. No heart rhythm on the monitor. No sounds of labored breathing.

As I finished my paperwork and called the funeral home, I was reminded of Grandma and how fast is was when she died. And I remembered the nurse in the hospice room at Holland Hospital and how caring and comforting she was, even though only hours before she had been a total stranger. I felt a lump in my throat as I hugged the lady who came to see him and suddenly my eyes felt like they were under water.

Later I talked to the man's son and signed the papers for all his organs to be donated. This patient's own son had received a liver transplant 10 years ago. The gift of life goes on.

And then I realized that I have the awesome chance to be Grandma's nurse. Monday I delivered a baby and heard his first cry in this world, and today I held a man's hand as his eyes closed for the last time. I've been told by weathered veterans of emergency medicine that after a while you don't care as much anymore. And I've also been told that I still care too much. But that's not a problem for me. I'm learning that death has it's own beauty, and if I get to be the gift of grace for one moment, then it's all worth it.