Without breath
the stillness of my body consumes me
erratic
uncertain
my heart is coerced to contract
a muscle no longer willing
a ventricle hardly filling
cells unable to fire
a body (un)-qualified to fight
agency pulled ever so gently
but ever so faithfully
until a tug of war exists
with no one on the other end to respond
but the wool has not been pulled over my eyes
lingering
waiting
wanting
the softness of death
inadvertently I'll be gone
vitality draining
quicker than the elixirs pumped into me
wide open
my body won't respond
futile
their curing-like properties
wasted
with good intentions
stealing
my anticipated hereafter
but another one ensues
that's
my saving grace
diagnosis uncertain
death undoubtful
certain as the collapse of my alveoli when they turn off the machine
certain as the rain on a stormy night in April
waiting for the soundlessness
unmoving
sense of vanquish that suffocates the room
and those three words can hardly depart the doctor's lips
don't they know
the saving they long for does not exist
that which stirs below the surface is invisible to my eye
beyond my peripheral vision
beyond my understanding
the sanctity of a closed eye
once thought impassable
except to those that pry open my eye and apply light to an unconstricting pupil
vacant
horizontal
I am at their will
the forced air pushing into my lungs
lulling me to sleep
like the perfect lullaby for the final song
pacified
persuading me
to vacate the body that has housed me for so long
“time of death”
fought to the last moment
but not by me
hoping sleep finds me soon
The (un)-definitive time of death
Many of us can intuitively feel death drawing near in a patient. Whether it is something the patient says before they fall to sleep, the colour of the skin, the shutting down of the kidneys, the cold that sheds from someone's body, or something as obvious as breath leaving the body and not spontaneously returning. And sometimes it is something so subtle, something so indescribable, but we know death is not far away.
Time of death — such a fateful expression. Such a difficult thing for most health care professionals to admit, especially when it is a patient you have come to know and respect, or when a family sits in the waiting room, waiting for you to tell them the fate of their loved one. Think of the bodies and people that you have “worked” on. Some fighting so hard to stay in this life, some fighting so hard to leave. As health care professionals it is a fine line between trying too hard and not trying enough. We can prevent death and delay death. How do we know when enough is enough? A question that still has no definitive answer.
Death is a common entity in the career of a doctor or a nurse. Most of us can all probably remember the first deaths we experienced in our professional lives. The one I remember vividly was a patient named Marie. I cared for her and her family, in her final days approaching death. I left her home at 11:00pm and she died an hour later. I remember getting a call in the morning, telling me I didn't have to go into work that evening. I remember crying as I drank my morning coffee. I wasn't “supposed” to cry. I also recall another patient who died when I was present in his home with his wife by his side. Death was expected in this case. It was just the three of us there. It was 3:00am when he died, and I was at a loss for words. What could I say to this woman who had just lost her husband? What was normal? What was expected of me? She wanted to help me clean him and make him presentable before the coroner and the rest of the family got there in the morning. We bathed him in silence, together. The third death that stays with me was a patient of mine who died in the intensive care. He was old, emaciated, and you could see that life had drained out of him. It was a night shift and his wife was present, a sweet elderly lady, with no other family or friends. She was all alone and I didn't encourage her to leave that night, because I knew. She sat by his bedside and told me stories of their life together, and she told me of her worries for the future. I listened, but I was again at a loss for words.
Death is a difficult topic to discuss and many of us attempt to avoid it all together. Perhaps we hope that if we avoid it, then it doesn't exist. Yet as rational beings, we all know this is absurd. Gila Strauch completed a thesis concerning talking about death and three words from her thesis have engraved themselves on my thoughts.1 Those three words are “sense of adequacy”. She tells us that experience talking about death may still not make us comfortable in talking about death, but it may empower us in the future to talk about death with a sense of adequacy.1 Talking with a sense of adequacy, striving for a sense of adequacy, when comfort is out of reach.
REFERENCE
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