Actually, it was liberating to write about death as Something. A persona. A Thing. Which I very often think of and experience it as, in the course of my ordinary (or not so ordinary) everyday (or not so everyday) work.
Last week, I took on a patient who was very near the end of his life. His wife, who had been married to him for 27 years and adored him (a second marriage for both of them, their kids were all grown when they married, and they exulted in one another's company, traveled together, and generally had a whale of a time together for nearly 3 decades) was not nearly ready to admit that he was dying. I spent my first visit with them just trying to manage his symptoms and give her some kind of idea of how to administer the medications he needed. When she said "he might get better, right?" I tried not to bring her down to earth too violently. After all, it was my first time meeting him and her, and I wasn't sure of anything. The next morning, I was completely sure. He was well on his way to dying, and I had to tell her that. I crouched down beside her chair so she was looking down at me (a position I always find most comfortable when I have really bad news to break): "Jean (not her real name)," I said gently, "he's not going to get better. This is it, he's dying. I'm so sorry Jean but you are going to lose him now."
Three days and seven visits later, he stopped breathing, at 4:45 on Friday afternoon. I stayed with Jean till about 6:30, filling in the paperwork for her to donate his body to science, and typing up an email to all their friends that she dictated, telling them that her beloved husband had just died and asking them to hold their happiest memory of him in their hearts. You don't get much closer to a person, and yet I'd only met her three days before.
On my weekends, I need to get a little distance from death. One good way to do this is to drive out to the beach and sit looking at the ocean. This Sunday, my 15.5-year-old newly permitted daughter drove me proudly out to Stinson Beach and we sat together watching the surfers get trashed by the high tide waves. I saw a 2-year-old boy kneeling staring quietly in the sand and I thought of my patient and how his spirit might very well be kneeling in that fine sand staring out to sea and bidding farewell to his life here on the land. So I wrote this poem for him and for his wonderful, brave, strong, pragmatic wife.
Hospice Nurse
When I show up for death
I take off my thousand pound weight
so I go in light
and I wait
there by the bedside
for death to look up.
There’s family: a daughter,
a wife, a son flown in
from the East Coast
and death thinks this is all
so fine, he has the elixir
for the dying man
in his coat, in the pocket
of his heavy coat.
But I am the hospice nurse
and I have something too
I have a comfort kit
for when death decides
to really come out with it
the twenty-one gun salute
the frothing
at the mouth.
After I lay down my cloak
for the dying man
and the son calls out “Dad!
dad! it’s me!”
it’s not good
or bad
but he can’t hear him,
he can’t hear any of them
he is on his knees in the fine sand
staring out to sea.
