THE LAST DEATH

Friday marked the end of my hospice career. At 1:00 PM, I was sent to evaluate a 92 year old woman in a nursing home. It was one of the least pleasant nursing homes in town and I always take one last sweet breath of fresh air as I open the front door. I did so on Friday and made my way through the long halls to find the patient in 46C. As I passed the med nurse in the hallway I told her who I was and she said, “I think Mrs. N. is close”. Now we in hospice say “active”, not close, meaning actively dying. I always find this an interesting word in that most of us think of death as a process of letting go and not as “work”. The reality is that it often appears to be work, to be a job to leave this world. When I walked into room 46 I saw Mrs N. in the corner and her breathing was very labored. I called her name and she didn’t respond. As I waited by her bed she opened her eyes and fixed them on the space near the window. She cried out softly and closed her eyes again. She was not aware of me.

I knew that if we admitted her to hospice, she would have one of our nurses come out, get meds that would make her more comfortable and provide great support for her family. I got to work. I called her daughter who lived out of town and explained what was happening. The daughter said she doubted that her mother was really dying because “she looked fine on Sunday when I was up there”. She agreed, though, to sign faxed consents so I started preparing five forms for her signature. When they were ready I inquired about the location of the fax machine. A very large nurse with keys opened the med closet, showed me the fax machine and began to leave. I asked a few questions about dialing 9 or 1 etc. and she answered me abruptly and left. I then started faxing and broke the machine. It wasn’t exactly broken but the little square screen had the message “open cover” and when I did, I found nothing wrong. I closed it but the message persisted. This went on for several minutes. All I could think of was that this lady was going to die before she could be officially on hospice. There was something wrong with that. It was almost as if the fax machine would be responsible for her death. No, worse, it was as if I WOULD BE RESPONSIBLE because I was too incompetent to operate this little machine. At that moment, the large nurse with the keys returned to the closet, asked how I was doing and then said VERY smugly, “We never have a problem with the fax.” In a few minutes the consents were faxed, signed and returned and I was able to admit Mrs. N. and then left to do my charting.

I won’t ever know if she died that hour or that day because I turned in my computer and my pager and left my job at 4:00 PM. I thought my last day was kind of absurd and then thought about death itself being pretty absurd. You spend a lifetime growing, learning, trying and failing and then trying and getting it right. You develop wisdom and appreciation for simple things like birds and the feel of a cool breeze on your cheek. You refine your love for everyone in your life and start loving them just as much if not more for their quirks and bad habits as for all their so-called virtues. You learn to laugh at all of it. And then it’s time to go. And sometimes it’s your fate to die alone in 46C with a little light sheet over you and somebody down the hall trying to send a fax to your family to buy you a little more comfort. God bless you, Mrs. N. God bless us all.