Friday, December 7, 2007

We Should Not Die Alone

One of my specialties when I was working as a chaplain was dealing with crisis situations in ER or ICU. I have always been cool under pressure, which was an asset when dealing with grieving families or families facing tough choices.

Sometimes I would have to try to contain the wild, demonstrative grief that had people flailing over gurneys and falling to the floor. Other times, it would be standing quietly while someone died with no family present.

That happened often when family members had been keeping vigil for days and days, and just stepped out for a short break. Almost as if the dying person wanted to do it alone.

But on rare occasions it was because family members did not care to be present for whatever reason.

One of the ICU nurses had a particularly hard time dealing with that kind of situation and called me one day in tears. A patient, who had been on a ventilator for several weeks with no hope of ever breathing without it, wanted the vent removed. She had two sons, who had seldom visited in those weeks, and they had different reactions when the nurse called to tell them what their mother wanted.

The first son said that was fine, and no, he did not want to come to the hospital when the vent was removed.

The second son said that was not fine, and he would come to the hospital with a lawyer if need be to prevent his mother’s wishes from being carried out.

The woman was conscious and able to communicate and had already signed a Do Not Resuscitate (DNR) order. The legal department from the hospital drew up another document outlining her most recent request and that was read to her before she signed it.

Then there was another conference call to the second son in which the doctor again explained that there was no hope of recovery for his mother, and we now had a document signed by her that she wanted the vent removed.

Legally, there was nothing else the son could do, but as the nurse said, if he cared that much about his mother to fight the removal of the vent, he could have cared enough to come and be with her when she died.

Everything was done to make the woman comfortable and before the vent was removed, I had a little service for her that she had requested. Then she nodded and the respiratory therapist turned off the machine.

The nurse cried. The therapist cried. And I cried. Not for the fact the woman died. But for the fact that she had to die with strangers around her bed.

2 comments:

Pam in Colorado said...

I can totally understand the person waiting until family left. I saw that many times when I worked with Hospice programs. Attentive family members leaving for a meal, a shower or a nap and the death occuring while they were gone.

I often wonder of the apparent cold heartedness of those who refuse to visit... is it just a cold heart or a deep rooted fear of death itself. Perhaps both.

I'm grateful that dear woman had you, not simple strangers, but loving souls who were willing to stand with her from life to death.

Maryann Miller said...

Thank you for the kind words, Pam. I'm sure that you have also been a loving soul sharing a blessed moment with patients.

Some people don't come, like that son, because of unresolved issues that had been a wedge in the family relationship. That had become apparent in the weeks while the woman was in the ICU and we had interaction with family. They were only there a few times, but it was enough to see that this was not a healthy family relationship.