Of hospitals and goodbyes, the coldness of medicine and the warmth of human contact

You wake up early, and realize you’re over on the other side of bed, curled up in anticipation of finding someone who isn’t there.  You don’t spend much time at home; a quick shower and a few minutes to check emails, and you’re out the door.  Picking out the right clothes is the only thing you do pay attention to; you’ll need to show up at work later today, so you make sure the outfit is professional looking.

The drive to the hospital is one you’ve done so often it’s become routine.  You park and hustle in along with the many nurses and other employees starting their shifts.   A quick stop to get a large coffee, and you’re up in the Trauma Level Care area.    This isn’t the normal part of the hospital.  There’s nothing ordinary or reassuring about it; it’s clear from the locked door to the low nurse to patient ratio that anyone in this area has major issues.

The 12 rooms are arranged in a circle around a command center, and you say good morning to staff as you pull open the curtain and walk into his room.  The first thing you do is check to see if he seems present.  You walk in and start talking.  You’ve read that even in a coma, people can hear and are aware of what’s being said in their presence.  This is a good morning; his eyes follow you and he squeezes your hand.  Next you check the white board in the room to see who his nurse is for the day.  The nurse is your life line, and the closest thing to an advocate you and he have.

The medical group you’re waiting for is on the other side of the room, and the nurse reassures you they haven’t yet visited his room.  That’s good news.  You’ve joked with staff that each of the doctor groups should have a symbol or insignia on the back of their white coats to identify them: the hospitalists, the gastric team, the renal doctors.  It’s not really a joke.

You turn on the eBook, drink coffee, and wait.  It’s hard to concentrate, but you’ve learned to pretend to look normal and composed when inside you’re screaming and yelling and crying.   Finally, the team approaches your door.  Back when all this first started you sat quiet and tried to listen when each medical group approached. No one; not the interns, not the lead doctor, bothered to include you until one day a substituting doctor asked if you wanted to listen in.  Now you hop up from your chair and join the group.

So, you sit and wait for the doctors to make their way to his room.  The group consists of 5 – 7 people.  Some clutch papers with patient information, one pushes a laptop mounted onto a cart.  The visit starts with the recitation about the patient; age, gender, a dry recital of diagnosis and current status.  There’s not much else.  The lead doctor comes in and checks a few things.  The main students walk in with him; the doctor asks a few questions of the students.   No one pays attention to you, it’s like you’re another piece of furniture.  A few days ago you hung up pictures of the two of you.  The nursing staff all made nice comments about the pictures; the doctors mostly ignored them.

You desperately want these people to realize that your husband is a human being, not just some sick body lying in a bed.  He’s a sentimental man who loves romantic comedies, a fairly good Thai cook, the kind of guy who has to stop to pet every dog he sees.  You get that the focus of doctors is diagnosis and treatment, but you really, really wish that there would be just the least little bit of compassion shown to the two of you.

Over the last few days, the amount of time spent in your doorway has decreased, and you know what that means; he’s not doing well.  Failing patients are not good teaching examples.  The other big sign is in how the younger student doctors deal with you.  They look spooked, no longer making eye contact with you, looking down and mumbling.  Clearly they think he’s dying and don’t know what to do, how to act.

Today is a special day; it’s your wedding anniversary.  You’re fairly sure it will be your last, but there’s still hope, a faint chance of making it through, and you’re not going to give up.  In one the greatest gifts you will ever receive, he’s focused and aware this morning.   You start talking to him, and amazingly enough he actually seems to be following your conversation and trying to talk to you.  Of course, with the tube down his throat he can’t talk, but you do your best to fill both sides of the conversation.  You remind him about the anniversary, and he nods and holds tightly to your hand. You tell him you love him and that he’ll make it through this.  He looks at you lovingly, but sadly, and squeezes your hand.   You talk a little more with him, and say those things you say to the most important person in your life.  You make sure he knows that you know all that he wants to say but can’t.  You try hard to smile and seem positive, but you can’t help the tears that start sliding down your face.  He matches you on that.

This whole wonderful encounter lasts about 15 minutes, and then he slides back into the realm where he’s spent most of the last month, not really present, not focusing, not being aware.  That was the last time you had the feeling he was there; it was your goodbye.

It’s a year later.  He didn’t make it; you became a widow 6 days later.   Today is your wedding anniversary, only this year it’s a remembrance instead of a celebration.

You started writing this post to talk about the lack of humaneness and empathy in the American medical system; about how terrible and frightening and lonely it was to go through that last month, and the difficulty in getting information and finding out what was happening.  You wanted to provide people who have never gone through an experience like this a window into what it’s like to be the main support of a critically ill patient.  You envisioned a political piece on the need to include family more in medical treatment.

Somehow, though, the post got away from you, and what started out to be a trenchant critique of Western medicine ended up being a remembrance of how your husband said goodbye to you.  And, you know what, that’s actually a better way to mark what would have been your 8th wedding anniversary.

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17 thoughts on “Of hospitals and goodbyes, the coldness of medicine and the warmth of human contact

  1. I’m sorry for your loss. Thank you for writing this. I recently lost my father in an ICU and I work as a nurse. You illustrate some important points. I know what you mean about seeing a vibrant person in the bed with tubes everywhere. It’s so hard to see loved ones in that situation. I think the medical community forgets that each patient is so much more than a disease and a bed number. They are husbands, wives, sons and daughters, and friends. I try to remember that every day at work. I am going to show my mom your blog. I wish you the best going forward. Thanks again for writing this.

  2. Thank you for writing this post. As an ICU nurse I too often feel that awkwardness of how to go about things at times. Since I work the night shift, I don’t usually see as many family members, but if they seem receptive to it, I love to ask them about their sick loved one, and how they met, and their life. I always hope that this is helpful for the family member who is visiting. Your post helps me to think that it is. I’m very sorry for your loss;

    1. I can’t answer for everyone, but for me the kinds of interaction you’ve described was so helpful and kind. It’s really hard to see a vibrant person reduced to a semi-comatose body hooked up to tubes. The hospital staff I had the most respect for were those individuals who were able to see past the equipment and still view my husband as a person, and to treat him as such, and to include me as a participant. There was one doctor who did that; and every single nurse. Nurses are amazing; I came away from this experience with a feeling of awe at how well you and your fellow professionals are able be compassionate and include family and still do that very hard job.

  3. I don’t think anyone truly understands what the family goes through unless they have been through it themselves. Thank you for sharing your story.

  4. Such a beautifully written piece. As my husband and I prepare to celebrate or 32nd anniversary he is about to get his next chemo treatment. He has stage 4 esophageal cancer. I sobbed as I read your words to him. Thank you for sharing. This is a unique kind of pain. I am so sorry for your loss.

  5. I am sorry for your loss. And I am sorry for the “cold” care you’ve experience in the ICU. But I will not disagree with you, that I wish we could always treat patients as unique human beings, and not just a blob of body hooked to different life sustaining machines. Thank you for sharing.

  6. This was such a beautifully written piece. I work in intensive care and, while I haven’t had this experience myself, I walk with people through it every day. I never know what is truly on their heart and mind, as I know they’re trying to be strong for themselves, their loved one, and the rest of their family. I appreciate your honesty so much. I know this post will bring comfort to others as you have written things that so many people feel but are unable to put into words. When I go back to work later this week and continue to care for people like your husband, I will have you both on my mind.

    1. Thank you so much. I could never have made it through that month without the wonderful nursing staff. I am in awe of all that you and your fellow professionals do. You manage to provide outstanding care while still being caring and compassionate. Nurses are the best.

  7. “but you’ve learned to pretend to look normal and composed when inside you’re screaming and yelling and crying”… beautiful piece. Atleast once a day something comes to mind, and it doesn’t seem real. {{{hugs}}}

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