Catching a glimpse of her corpse as I entered the ER and shaking off the old memory that I couldn’t quite place but knew was located somewhere in the deep recesses of my mind, I darted by. Not really having much time, my head had only turned towards her room for two seconds at the most as I hastily entered through the ambulance bay to relieve the night doc. I was late. It was 6:02 and time to start my morning shift before the sun had even risen. Her imminent death hit me just in that ephemeral moment. There was no way I could possibly know her story but something inside me felt her familiarity.
“What the hell is in room 13?” I heard myself question before I even managed to say good morning to my sleep deprived colleague as I turned the corner, found my chair and logged into my computer.
“Sorry to leave you this but she just rolled in. She’s a hospice patient and has cancer all over her body. She was about to die peacefully but her husband revoked her DNR and called 911 instead because he got mad that the nurses weren’t draining her tubes and threatened violence against the staff. She could code any minute and now her husband wants everything done to save her from the inevitable-death.”
The chaos and frustration were palpable, especially in the voices of the nurses. Hearing one mumble that the husband must be getting a social security check as surely money could be the only motivator to allow him to torture his wife like this by prolonging her suffering, her age on the computer screen popped up. She was only forty-one. Opening her chart, I initially gasped and then laughed at the intimacy I had initially sensed. She had metastatic ovarian cancer. This was my friend Rhonda.
Granted Rhonda had passed several years ago from her disease at the same age but I now understood the immediate connection I felt for this dying woman that I hadn’t even met yet. Walking into her room, the smell of death wafted through the stagnant air as she exhaled rapidly the putrid toxins that her dying cells were so rapidly trying to rid her body of to no avail. Her labored respirations and gurgling froth coming from her dry, opened mouth were about the only signs that this woman was still alive, but just barely.
She was completely unresponsive, even to the pain of the multiple needles that were repetitively pricking her skin in an attempt to keep her heart beating. Although her face was thin and gaunt, the rest of her body was completely swollen like a toad to the point that her yellowed skin was leaking fluid onto the bed sheets. Pressing her legs with my index finger left a deep, canyon-like indention of my print in her weeping skin.
Pulling back the covers to get a closer look, the multiple tubes coming from her chest and bloated abdomen begged the question. Is he going to make me insert another one? Touching her right shoulder, I prayed she could feel the energy of peace and love as she made her transition.
“What are you going to do? What are we going to do?” the nurses all questioned, thoroughly disgusted by the scene.
There was no blame to feel towards them no matter how callous some of their looks became. Being forced to torture another human as most of us saw this went way beyond our ethics. It actually felt sinful to the majority present. It never felt right to do the wrong thing by the dying. But I had been learning that really wasn’t my decision to make.
As I saw it, we were going to be caring for her family more than her. My heart was telling me that she desperately needed our help just not the kind that would save her life. That was not possible. Her time was approaching. But from what I had gathered from the accounts of the hostile scenes that had been made by her husband, he needed our resuscitation skills.
“Get me a stat chest x-ray and her lab work. Then I’m going to call her husband and let him know the status of his wife.”
He had apparently fled the scene as soon as she arrived. Everyone assumed he had just dumped her on us so he didn’t have to watch her die. It happens all too often. It is hard to watch anyone die let alone your wife. My mind recognized that I had no idea what I would do in his situation as I had never been there. My plan was to just talk to this man after her results were back so I could show him the big picture. I sensed he was really going to need that. It was almost as if by touching her, she had told me so.
“Hi, Mr. Reeves. I’m the doctor that has taken over the care of your wife. I’m hoping you are close by so that I can sit down and talk to you about your wife’s results and current condition.”
He returned within ten minutes of my call with his sixteen-year-old youngest son in tow. His sideburns, mustache and shoulder-length brown hair did not disguise the scowl he wore right below the brim of his cap-blazing a rebel flag. My guard still had not gone up regardless of how tight, flexed and aggressive his body language appeared.
“His wife is dying. The mother of his children is taking her last breath” I kept thinking to myself. “Be compassionate. Be a shoulder. Be his rock.” Was she sending me messages?
Even when his hands began to make fists instead of shaking my outstretched hand, I gently sat down and asked him to tell me the story of his wife. I needed to understand everything in order to help her and him. Maybe it was Rhonda keeping me so calm as he cornered me with anger in his eyes.
And then they softened as he took a deep breath.
“I’m sorry. We have been up for the last thirty hours. I’m close to delirious but I couldn’t just let them treat her like that. I couldn’t have her die there like an abandoned animal, not after all that she has been through.”
Saying not a word, I listened as he recanted his version of the truth. He had been able to keep his wife at home up until yesterday afternoon. She was still talking to him when he finally resigned himself to allowing hospice come pick her up and take her to the nursing home for closer care. They had been coming into the home, making her comfortable but she was getting much weaker. He was scared to leave her at home for any length of time while he delivered pharmaceuticals to continue to put food on the table for his family.
“They told me they knew about her special drains. They made me believe they could handle her situation. I knew she was at the end but they did none of the things they promised!”
When he arrived at the nursing home he found her drowning in her own fluids. None of the drains had even been touched. He ran to her bedside and quickly released the valves, drawing liters of fluid from her lungs and belly. Her breathing improved but she never woke back up. Yes, he was angry and yes he may have caused a scene but he would die himself before he allowed her to be disrespected and as far as he was concerned that was exactly what had happened. He felt he had no other choice but to call 911 in hopes of finding real caregivers in the ER.
“She was doing so wonderfully until we moved back here. The new doctors changed her chemo and had her convinced that the chemo they were giving her in Buffalo wasn’t the right stuff. It all went to shit in five months because of those damn doctors. They convinced her to die.”
He was clearly needing to blame someone for his horrible circumstances. I got that. I let him rant and blame on until he commented that ovarian cancer was supposed to be slow growing. Then I had to interrupt to correct his heresy.
“Sir, I’m sorry but that is misinformation. Most people are dead in only a few months after their diagnosis. Ovarian cancer is rarely found until it’s too late,” as I thought of Rhonda who had not even lasted one month.
He looked at me like I was crazy and had certainly not gone to medical school.
“Well, MaryJo has had it for fourteen years.”
In disbelief, I was now interrogating him. “You mean to tell me that your children were three and four years old when she was diagnosed?”
“No, they were two and three. The doctors in Buffalo saved her life. They did things that were completely unheard of back then. The chemo and the surgeries were state-of-the-art and probably even experimental but she lived. She lived a good life for fourteen years until these damn doctors in Georgia got a hold of her. I should never have brought her back here.”
“Why did you?” It was not an accusation. I was genuinely curious. But then I saw it. His face changed completely. He dropped his head to avoid meeting my eyes. He was full of guilt and shame.
“The winters were brutal and I got offered a better job.”
You could hear the sorrow in his voice. He didn’t really fault the doctors and nurses for his wife’s demise. He condemned himself. He had exchanged warm weather and money for her life as he saw it. He was full of regret as he tried to hug his son who had been quietly sitting on the couch across from him as the tears silently rolled down his cheeks, inching away from being touched by the murderer.
“Oh God, I’m so sorry. I’m so sorry I let this happen,” he wailed.
“Sir, I’d like to say something to you if you don’t mind. It won’t make your loss any easier but I have to say this,” it was as if Rhonda was sitting right there, pummeling me in the shoulder to speak up.
“I am so very happy for you and your sons and for MaryJo,” continuing to speak even through his brief revulsion.
“I feel so much gratitude right now even while I sit here witnessing all your pain. You all have been given an enormous gift. You were given the gift of life for fourteen years when really these children would never have gotten to know their mother under most circumstances. In reality, she should never have seen her young toddlers grow into men. She should never have seen how you could love, provide and hold a family together through such tribulations. You, sir, have been given an enormous gift and I just want to thank you for sharing it with me.”
And then I told him about my Rhonda and how quickly she was taken from her family, from her loved ones. I told him about all the many women with ovarian cancer that I had treated that left this earth so quickly.
“And that guilt you are holding on to; it is time to lay it down. You have a decision to make and no good decision is ever made from guilt,” quoting a friend that had just given me this same advice only days prior.
I then went on to share his wife’s current condition. She was in septic shock. She had an overwhelming infection that was shutting down all of her vital organs. It wasn’t his fault or the nurses at the hospice center or the Georgia doctors. Her immune system just couldn’t handle this toxicity.
“And now it is your time to tell me what you want me to do for your wife.”
He didn’t think twice before he spoke.
“I want you to make her comfortable. I want you to give her peace.”
I escorted them into room thirteen to be with her in those final moments.
We couldn’t help but hear as her son’s cries filled the halls over and over, “I love you, mama! I love you, mama”
And then we as caregivers were blessed to witness the ultimate gift that this husband afforded his beloved. The ultimate gift of unconditional love. MaryJo was finally at peace.
And then life went on for us in the ER as more patients rolled in commanding our help. I happened to glance down at my Facebook page on my phone. I just shook my head in disbelief.
No wonder MaryJo had come to visit me on this day. It was the one-year anniversary of my flight to Tokyo to run the Tokyo marathon in honor of Rhonda and ovarian cancer awareness. Her sister Heather had just posted the memory. It finally made sense why I had felt Rhonda all around me. She had been there all along helping me and this family and MaryJo.
And now I believed more than ever…
No good decision is ever made from guilt
but those made from love will bring peace.
