Monday, February 19, 2018

Sudden traumatic death vs lingering death. They both stink.




Where you used to be, there is a hole in the world, which I find myself constantly walking around in the daytime, and falling in at night. I miss you like hell. 
~Edna St Vincent Millay



So, as you know, I have seen a lot of death. And, as you also know, I have been and continue to work in hospice. But when I was a younger nurse, I worked in the ICU and the ER for a few years. I saw less death than in hospice, but I saw a different side to death.

The unexpected.

A lot of people tell me, when I say hospice, that they would rather die suddenly, or in their sleep, rather than have a lingering death. Most have neither experience with losing someone in either way. Or some have lost someone to cancer or another debilitating long term disease such as Alzheimer's. None have lost someone unexpectedly or traumatically.

Because those survivors would never say that.

Time is a gift. It may not feel that way initially; it is very hard to watch someone decline. But it still remains a gift. The dying get to say goodbye. They can tie up loose ends. They can make amends. They can die on their own terms. If lucky.

 They leave behind the bereaved, and while you can never really prepare for a death, it is more of a gentle wave than a sudden storm.

But the sudden deaths.  Those haunt the most.

One afternoon, many decades ago when I was in my 20's and working in the ER,  a call came in from an ambulance with a 2 minute ETA. They had on board a 15 year old. In full cardiac arrest. We had to question them. 15? Yes, 15 came the response.

The ambulance pulled up.  The team ran out and brought the young boy in. He had on gym clothes and white Nike high tops. He was intubated and being bagged. When we put him on the monitor, it showed asystole. But we worked on him, for over an hour. Finally, exhausted, we reluctantly called the code. This young boy was dead.

A nurse came in and got me. She told me his mom was here.

The ER doctor and I went out. She was in the hall anxiously awaiting seeing him.

"The school called me and told me Matt was injured in gym class." She was looking at her watch, she was a bit annoyed actually. We had called her away from her work to come in.

"Please come with me" I said. And we guided her to the family sitting room. Once there, she looked confused. "Is he in x-ray now?  I really must get back to work. His father will come pick him up."

The doctor and I looked at each other.

The doctor laid his hand on her shoulder and encouraged her to sit down.

He then said, in a very soft voice, "we did all we could."

She looked at me, confused. Then she asked the doctor, clearly annoyed, "What are you talking about? Did he break his leg? Sprain an ankle? Oh no, did he hurt his head?"

And then, after clearing his voice, and in a matter-of-fact way, the doctor said kindly, "No, your son died."

And then, just like that, all the oxygen exited the room. There was silence for a moment. There was a loud, guttural gasping sound.

  Then, laughter.

The woman stared blankly at the doctor. Then at me.

"You two are idiots. My son was hurt in gym class. The school said so. Honestly, you have me mixed up with someone else."

Then, suddenly, the door opened. A volunteer had a crying man with her. It was the gym teacher.

"Oh my God, he just collapsed during running drills. We started CPR right away. I am so sorry." He ran to her and hugged her briefly.

Then all hell broke loose.

It was like a huge wave came out of nowhere, sweeping up everyone and everything. Palpable anguish. Loud screams. Hell.

The mom collapsed on the floor. We helped her up and asked if she were okay.

" I will never be okay again."

And that is true.

All death stinks. We lose someone and the heartache is eternal. But when you had dropped someone off at school in the morning, with your mind on not being late for a meeting, and maybe even yelling at your son because he made you late, it is unimaginable. People return to that last moment time and time again. They want a re-do. They want to say I love you. They want to have that chance again to let them know that they are the world to them. That anguish is relived every day. On holidays and birthdays and when they see his friends reaching lifetime milestones.

 And sometimes, just for no reason at all. Like a huge rogue wave that rolls out of nowhere.

This past week, 17 people went to a school and never came home.
Replicate that by thousands.

 There are so many unfinished lives out there. Not just for those who died, but for the survivors. They had a life unfolding with people that were center to that life. And now the world is off that axis. Now the world has this huge hole in it. Some people fill it with anger. Some with silent retreat. Some with a cause to fight. Some with absolutely nothing. They go through their days like ghosts.

Life is a gift. So is time.

Use it wisely.