No bad poetry tonight. Two of my patients died yesterday and I'm just sitting with it tonight. I remember all my patients and some always stay with me more than others. These two were something more though I don't know why just yet.
They were both 51. I "met" T. during staff meeting two Mondays ago. The nurses started passing around photos of T.'s wounds - eight stage 4 wounds, the worst any of them had seen. They loved it, literally. A lot of the nurses will say they just love wounds. And they do. Most of the chaplains and social workers declined to look at the pictures as they went around, but T. was assigned to be my patient, so I thought I should look. This was a major piece of his reality, so if its my job to understand and support him in his reality, I thought I ought to look. So I did. And it was bad. I had to concentrate on nothing but suppressing the gag reflex for a few minutes. Slough, tunneling, green drainage. Right to the bone. His body, literally, rotting off of him.
I saw him three times on three different days and he was in excruciating pain despite the huge doses of morphine Deb, the nurse, put him on. He had a tremendous quiet dignity. Each wound was colonized with MRSA and VRE and so no touching allowed. He wanted to see the Atlantic again. I had it lined up to take him by ambulance to Plum Island with Deb and Heather, his hospice aide. I got permission to drive the ambulance onto the beach from the wildlife refuge rangers and we were going to back on, open the bay doors, crank him up, and - Atlantic. I knew it wouldn't happen because he was going to die too fast but I made the calls anyway and got the funding. It just felt right to do that. In the end I sat beside him and talked him there instead. He was just a truly lovely guy and he had really nice friends and family who all came to see him. I last saw him Monday as he was dying and I touched his hands and kept my hand on his forehead for a long time. Totally not supposed to do that, a little stupid to do that and likely got the second viral pneumonia because of it but I had to. It was the right thing, for me at least, to do.
J. was also 51. Mother in this unbelievably gracious Lebanese family in this tiny apartment in the junky part of Methuen. Breast cancer for 13 years that when we came along had metastasized to her brain and liver and probably lots of other places too. She had this very calm, peaceful and luminous quality to her. And an extremely cute little funny giggle. She loved us and we loved her. The Monday before Thanksgiving the family made us a Lebanese feast - the chaplain Jim, Beth the nurse, and me. Their kitchen table moved into the living room and overflowing with homemade everything - beautiful, fresh vegetables, grains, pomegranate seeds, avacado, beets, tabouleh, grapes, pears, apples. I had to tell them the whole thing about not giving us gifts and just leting us come and be of service - the whole office policy speech, but we ate with them and said we would never tell if they didn't just don't do it again because how can you refuse an offering of self like that? And they understood, though G., the husband, took to kissing me on top of the head and telling me and Beth that we were his daughters and that he was going to buy us homes in Lebanon. That afternoon was the last time J. got out of bed. Jim led a prayer and we all held hands in a circle and I'm not a praying sort but I will say it was one of those moments and in my memory we all did sort of float up in a circle for a little while, it was so light, and joyful. And J. died yesterday morning and Beth was there and she said the sunlight was streaming in the windows. She called me right afterwards at 8:30 in the morning even though it was my day off. And sunlight was streaming in my windows too. So that was good.
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