Listening

It was an overcast Saturday as I made my way down the hall, examining one elderly patient after another at our in-patient hospice unit. Mr. G was alone, his room dark. He didn’t respond to my voice. I wasn’t surprised:  his nurse had told me he was close to death and appeared comfortable.

I reached for his wrist to feel his pulse with one hand while I placed my stethoscope at the bottom of his sternum. No radial pulse. But the sound of his heart was remarkable: a thrumming, a quivering, a vibration, a sound I’d never heard before but instinctively recognized. He was in ventricular fibrillation, his heart was flailing.

With an eerie feeling in my own heart, I quickly looked around the room to see if he and I were still alone. I had the distinct feeling that the curtain between this life and the next was parting.  Twenty seconds later, his heart was silent. He had stepped through that thin space.

A year later, again during a weekend I was on call at the inpatient hospice unit, a nurse called to say that Mr. R’s breathing had changed, and his family requested my presence. I entered the room to find his relatives crowded around the room on every available surface—watching him intently. I introduced myself, then reached for his wrist and placed my stethoscope on his sternum only to hear that now-familiar vibration, the final shuddering of the heart muscle. His breathing slowed, and I told the family we were witnessing his final moments. No one moved or spoke; we were all holding our breaths alongside Mr. R.

In less than a minute, he stopped breathing.  The quivering stopped. His life ended, just like that.

Here with us one minute and gone the next. It’s no wonder we struggle to make sense of the leave-taking, no wonder it’s so hard for families to imagine the close of life. In the hospital, we don’t hear the sound of ventricular fibrillation because we’re too busy watching monitors and “responding” to listen.

In each instance, the fibrillation sounded exactly as I would have expected: irregular, chaotic, disorganized. Yet in the quiet spaces of the hospice unit, ventricular fibrillation carries a different significance. I felt I had been granted a special privilege to bear witness, to hold each man’s hand as he crossed over, to accompany him partway and then . . . to let him go.

Nancy L. Glass
Houston, Texas