Days before she died
my mother stood in line,
took a picture for a passport—
For months, as I’ve visited Evan as his hospice social worker, he’s been praying to die. In his early nineties, he has been dealing with colorectal cancer for more than four years, and he’s flat tired out. As he sees it, the long days of illness have turned his life into a tedious, meaningless dirge with nothing to look forward to other than its end. He’s done, finished. He often talks about killing himself.
On this visit, though, his depression seems to have lifted. He’s engaged and upbeat–and this sudden about-face arouses my suspicions: Has he decided to do it? Is he planning a way out?
A pacemaker and defibrillator
Sheets pressed hard with suffering
Seven fingers and one arm, gangrenous dead
Unknown liters of blood
Failed kidneys
Gearing up for my night shift in the COVID-19 intensive-care unit, I don my personal protective equipment (PPE)–a white plastic air-purifying respirator (PAPR) hood. The hood connects via a tube to a large battery pack that I strap onto my waist over my scrubs. I turn on the battery and shiver when the rush of cool air blows past my ears. I walk into a bright white antechamber where a safety officer inspects me.
“You’re good to go,” she says. “Stay safe.”
As a pulmonary and critical-care medicine fellow, I care for patients with a broad variety of respiratory ailments. But little did I know, as I examined my patient Mr. Smith in the outpatient pulmonary clinic this past winter, that I’d see him again only months later as my first patient with COVID-19.
Mr. Smith was tough as nails. A stoic retired steelworker and former smoker, he suffered from significant emphysema, but was inclined–by nature and by necessity–to fight through his symptoms with limited medical help.
It’s winter of 1993. A cold, snowy day. Windy. A blizzard. The phone rings.
I’m not on call for my patients today–except for one. Daisy has been in my care since the early 1970s, and given the risk that she may suffer a serious downturn, I’ve instructed her nursing home to call me whenever necessary.
The day began in Mom’s room with a 10:00 am conference at Upper Valley Medical Center, west of Columbus, Ohio. In attendance were my ninety-three-year-old mother Joanne (now in her third week of hospitalization), her palliative-care nurse Richard, her Episcopal priest Mother Nancy and myself.
“Deeper compressions! Deeper! Make sure you get that recoil!”
I push harder and lift off higher. I’m starting to sweat. My stethoscope is banging around my neck. I should have taken it off, I think. My hair is flying around my face. I should have tied it up. I’m on tiptoe; my legs are cramping. I should have stood on a step stool.
“All right, she’s getting tired. Next!”
Embarrassing…I only lasted through one round of compressions. Other people (taller, more muscular people) are lasting longer. I really need to lift weights. Doing chest compressions is much more physically demanding than I’d thought.
My first day on the wards,
the senior resident handed me a white coat
emblazoned with the twin serpents of Asclepius,
and a stethoscope I proudly draped around my neck.
I thought I knew everything
about the dying patient assigned to me.
I listened studiously to John Doe’s lungs
filling rhythmically from a little machine
with a red diaphragm that pumped up and down
and made a hissing sound that reminded me
of the snakes embroidered on my collar.
I grew to know him over weeks,
to speak in code through a system of lid blinks–
the only muscles intact after a brainstem stroke.
I arrive in the memory unit at 1:30 in the afternoon. Jean, my mother’s sister, is fast asleep in her hospital bed in Room 1410. For the past ten years, it has fallen to me to be her frequent visitor and care monitor. I do this willingly because without her generosity and compassion, my life would have been far less meaningful and enjoyable. She never married, but my brothers and I honored her on Mother’s Day. My brothers sometimes drive here from their distant homes for a bedside family reunion.
During her decades of charitable work, Jean was named Recycler of the Decade by the New Jersey Department of the Environment, received the New Jersey Pride Award from
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