He sits at Anna’s bedside, unnoticed, working a crossword puzzle. Sometimes reading. Sometimes just waiting. Watching. Counting breaths until it’s time for him to do his job. Anna knows He’s here. She’s been expecting him.
Even though she cannot speak, I can hear her words to him, “I’ve been waiting for you,” Anna says. Her eyes are closed but she sees him. “Why are you taking so long? I’ve been ready for a while now.”
He lays the puzzle aside and leans toward Anna. “You may be ready. However, time is not ready. It won’t be long. A few loose ends to tidy up, then we’ll be on our way. Patience.” His voice is deliberate and slow, but also soothing. She doesn’t fear him as some do.
He pays no attention to me. He’s used to me and knows I am one of the few who can see him. I feel He doesn’t like me much since I’m keeping him from doing his job. But He understands this is my job, and in some cases I would rather that he do his.
The families are the ones that have a big problem with him. But He’s actually good to have around for a patient, like Anna, who’s ninety years old, has had a major stroke, is pierced with I.V.’s, penetrated with feeding tubes and catheters, and now connected to a ventilator, fighting pneumonia. The family is hoping and praying that Grandma Anna will get better even though the stroke has made it impossible for her to swallow, talk, breathe on her own, move her right side, or recognize anyone. Her systems are shutting down.
As I check the alarms on the ventilator and suction a massive amount of mucus out of Anna’s lungs, He waits in the corner watching everything. A family member arrives and asks me if there is any improvement and I tell them there have been no changes in her condition. I glance at Him. He knows what I want to say to this family.
I want to say that Anna is already dead. She died yesterday when she stroked but the rest of her body hasn’t caught up yet. And you, Family, wouldn’t allow her to die peacefully. Instead you wanted everything possible to be done to keep her alive. So we pounded on her frail little chest. I heard her ribs popping under our urgent hands. We stabbed her numerous times for I.V.s, central lines, and arterial blood gases. We shocked her again, and again with 300 joules of electricity to revive her tired heart. I inserted a large metal blade down her throat in order to introduce a breathing tube.
Now, hooked up to this ventilator and multiple drugs, she is alive. But is she living? No. Some would say I’m cynical, cold and jaded. Perhaps. Over the years I’ve seen way too many families keep someone alive because they are feeling guilty about something. Or worse yet, they can keep collecting Grandma’s social security check, or pension if she’s still alive.
Death sees that it’s not time for Anna yet. Our efforts, our machines and drugs continue to prevent him from doing his job. So He nods to me and moves on to another patient. There is always work to be done.
Header photograph: By Adrian Boliston (Flickr: Hospital) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)%5D, via Wikimedia Commons