Wednesday

This evening I got to a facility late to squeeze in an admission before going home. Tired, hungry, earache. I didn't think I could get an earache anymore. It hurt a surprising amount all day. I go in, review the chart, write a few notes, check in with the nurse. The patient is new there, arrived from the hospital yesterday, a transfer from another nursing home. She was in the hospital just long enough that the other home couldn't keep her bed open. She's 102, and lived at the other place for the past 10 years. Court-appointed guardian signs the DNR and authorizes hospice. So I'm here. Now she's here and an unknown.

Dying. Jaundiced. A double room made a single for her. Busy outside in the hall: dinnertime. No food in here. She hasn't had anything to eat in 2 weeks. No liquids for a couple of days. I see the urine in the catheter bag is tea-colored and scant. Won't be long. Unresponsive. I am so tired. My ear hurts. Her breathing is nice and even, shallow, skin yellowy and smooth, face relaxed. Its very quiet in the room. Window looks out over a field, grey and misty outside, grass is tall, red barn. I crack the window.

She's outlived everyone she knows. One son, predeceased her. Both grandkids too, her siblings, their kids, their grandkids. Everyone. I read the chart, I know. I go bother the nurse for a folding chair, sit next to the bed. Reach under the thin white coverlet and find her hand. Cool. I take a peek: a little bluish I think, hard to see in the fading light and that far under the coverlet. I hold her hand gently layered inbetween both of mine. I look at my watch. If I leave in 8 minutes I'll make it home for O.'s bedtime. I look at her face. So smooth and unblemished and lovely for 102. I close my eyes. I say this, "I know this is not where you are used to, but this is a safe place. Everyone here cares for you and will help you and this is a safe place. My name is Betsy and I'm a friend. I'm holding your hand. Your family loves you. You're safe here. I'm right here with you and its a beautiful evening, cool and misty. Its OK to go when you're ready. I'm so glad to be sitting here with you. I love the feel of your hand in my hand. We're in no hurry, you and me. We can take our time and go when we're ready. Its so peaceful here together. I'm so glad to be here with you." I think for a minute if this is the right thing to say to her. I decide its the truth, and the best I can do.

I mean what I'm saying even though its still true that I am tired, and hungry, and have a crappy earache, and want to go home, and want to make it for O.'s bedtime. Both are true. I close my eyes and put my head, just for a second, against the metal siderails of the bed. It feels good. Then, she dies. I open my eyes, look at my watch, start timing. No respirations. I stand up, still holding her hand, put my ear close to her mouth. No air. I turn my face and look at her. I say this, "Goodbye, ______. Thank you. I wish you love. I wish you peace". I put my hand on her forehead and rest it there for awhile. I go get the nurse and she does the pronouncement. I call and leave a message on the guardian's voicemail at their law office so they know. I leave a message on our report line for the staff. I call and notify the funeral home. It always makes the nursing home staff happy when you do that so they don't have to.

I drive home and can't find anything on the radio that seems right. I try the Decemberists disc focusing on #8 and #14 as recommended by the friend who gave it to me. #8 works, I turn it up loud. #14 I'm still not feeling. I drive too fast on the highway to make up some time. Far left lane the whole way. I wonder if I get pulled over by a cop if they'll cut me some slack because of the hospice badge and lanyard. Would I lie and say I was on the way to an emergency sad situation? I play this out in a few versions the rest of the way home. I get home past bedtime, but O.'s still up. He caught a catnap in the car on an errand with Dad, has a little reserve, I do bedtime and we have a snuggle and its nice. I think about posting on Facebook, BSD is spent, weary and earache, but don't. I tell M. I'm spent, weary and have an earache. He makes me dinner, brings it to me, cleans my plate up. My chest feels full and I can't get it out. We watch a little Cold Mountain, and parts of it are really sad, and I cry a little at the sad parts, and that helps.

I say goodbye, out loud, to her full name as I'm brushing my teeth. I close my eyes for a minute when I say it and stop brushing, water still running. I say it one more time. Goodbye, _____. I feel better. I take ibuprofen and tylenol both for the earache and hope it works, and hope it isn't too terrible for my liver.


Then I do this.


Goodbye, ______.