His steps are wobbly. Our children hold their father’s hands to steady him as they move through the sand toward the ocean. I remain far back on the shore, shading my eyes to make out the three of them as they stand in the shallow water.
I am thinking that he looks like a ten-year-old child from this distance. My sight turns blurry, a combination of sun, sand and sorrow.
All too often in my forty years of practicing medicine, I’ve seen patients die hard, lonely deaths—lying on a stretcher under the emergency department’s glaring lights, or all alone in an ICU bed.
In extreme situations, the patient is covered in medical equipment: a breathing tube in the mouth, defibrillator pads on the chest, monitor leads on the torso, IV lines dangling from the neck and arms. When family members finally enter the room, it’s
I was in my third year of medical school, partway through my psychiatry rotation.
“You’re ready for your first mental-capacity consult,” my attending said. I felt excited at being deemed ready to administer this evaluation, which is used to determine whether a patient has the ability to make decisions about their own care.
“The medicine team is confused about this one,” my attending continued. “He’s clinically improving from his COVID infection, but he wants to
Bang my shins, my temple on the gritty wall
Of Charlie’s deathbed
Where we do not wrest the truth
But beg him Let us change the (piss-stenched) sheets.
He will not go for tests, insists, denial overarching
I knock on the partly open door and peek around the curtain. A grainy yellow light above the hospital bed falls on a frail, trembling woman as she struggles to comb her wet grey hair.
“Margaret?” I say quietly.
She does not hear me over the hiss of the supplemental oxygen. I watch her for a moment longer.
It was a Thursday morning, my first day on the medical oncology service. I hurriedly gathered my white coat and badge, the block letters “3rd Year Medical Student” unmistakable in fresh ink. Taking a deep breath, I forced myself to look up at the cancer center.
This is going to be difficult, I thought.
A full head of white hair.
Each in its place.
Not just neatly.
Meticulously.
Perfectly.
A full head of white hair. That’s what I see in my minds’ eye, when I close my actual eyes and conjure up my grandfather.
My husband George got to know Ruthie while he was sitting with his mom during her final days in an assisted-living facility. Ruthie, a hospice worker, was a middle-aged woman who had reentered the workforce after raising her kids. As a nursing-assistant trainee, she was learning on the job, with George’s mom, unconscious and steadily declining, as one of her first patients.
Soon after meeting Ruthie, George was struck by her lack of self-confidence.
From the computer screen a few inches away, Oliver’s honey-brown eyes gazed into mine in the unadulterated way that only children’s eyes can, matching the directness of his question:
“Is he going to die?”
I don’t know what it’s like on the other side of the mask.
Not the cloth mask, which I now wear every day, as habitually as my socks. I mean the plastic bipap mask, which provides the highest level of ventilation COVID patients can receive, short of intubation.
That mask.
“After eighty-five years of life, I still don’t know what death is,” said Lonnie, as I sat beside her bed in the nursing home. “I just know it scares the heck out of me.”
Despite decades as a hospice social worker, I don’t know what death is either; but I’ve spent much time with patients exploring the question together.
“What scares you?” I asked.
Days before she died
my mother stood in line,
took a picture for a passport—
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