I strained as I pulled the comb through her matted blonde hair. The knots were bound by the glue from the electroencephalography that days prior distilled into numbers measured in voltage the fact that this 31-year-old woman would never again hug her children. Her body bore the marks of hospitalization. Gauze and tape adorned her hands and forearms. Bruises in various stages of healing acted as timestamps. From between her dry and cracked lips, an endotracheal tube protruded. With a health care system strained to its limits, there was only time for what was essential for life. But in that moment, there was no preserving life. She would die at precisely 10 am.
Leanna was one of the 24 patients on the unit, all having, most dying of, COVID-19. She collapsed at home and was brought to the hospital and diagnosed with a blood clot in her brain. There was enough damage that she would never wake again.
I glanced up at the clock. 8:45 am. Leanna’s husband was to arrive at 10 am to see his wife for one last time. Over the next hour I braided Leanna’s hair, moisturized her lips, removed unneeded tape from her body, and rid the room of the miscellaneous medical paraphernalia used to try and salvage her life. With care, I turned her head toward where I set a chair for her husband to sit. Atop the sheet, I placed her hand for him to hold. I looked at the clock. It was 9:50 am.
I heard a knock at the door. The charge nurse stood beside Leanna’s husband. In the age of facemasks, the eyes are all we have to discern the emotions of others. His eyes were heavy and wet and bore the look of immeasurable loss. I beckoned him in. He sat in the chair beside his wife, shoulders hunched in helpless despair. I hadn’t spoken in person with a patient or family member in weeks. I was suddenly acutely aware of my appearance. A yellow isolation gown hung flaccidly around my body, my face hidden behind a face shield and mask. Studies say only 7% of communication is verbal. If true, language is woefully inadequate to bridge the gap between the disparate experiences of two individuals.
“Hello. My name is Hunter. I’m Leanna’s nurse.”
“Brad.” He was disinterested.
“Listen,” I said, “I can’t imagine what you are feeling.”
“What? I can’t hear you.”
With the mask muffling my voice and the omnipresent sound of monitor alarms, words too, were strained. I grew irate at the situation. The inability to talk. The inability to connect. The inability to touch. I spoke loudly.
“I know you can’t see me and can hardly hear me. I can’t begin to imagine the enormity of your loss.” I paused. “And you know damn well I would be lying if I pretended I did.” His eyes glanced toward me both in surprise and in respectful acknowledgment. Sometimes, professionalism acts as a barrier to connection. “All I have to offer is space and time with your wife. But please know, this is not an average day at work for me. It is not normal. It is not routine. Like I said, I will never know the extent of your grief nor the profundity of your loneliness. For what it’s worth, I am going to remember you and Leanna for the rest of my life.”
His eyes looked vacant. He looked toward me, and then past me. Behind me, through the sliding glass doors, he could see into 2 rooms on the other side of the hall. Other patients, intubated and sedated, lie naked for the purpose of providing expedient care. Their hair unkempt. Medical equipment strewn about the room. He looked back toward his wife. Her hair neatly braided, sheets immaculately straight with her hand there for him to hold. He looked at me. There were no words and no facial expressions. Just two sets of eyes locked in an ancient, unspoken knowing. “Thank you,” he said. It was the most earnest and sorrowful expression of gratitude I’d heard. I held his gaze and nodded in acknowledgment. I left the room and watched through the window as the respiratory therapist removed Leanna’s breathing tube. She took 3 small gasps and fell still. On the monitor beside me, I watched her heart slow. Brad held her hand as she died.
I got off work and drove deep into the desert. I turned off the highway and headed down a dirt road and until headlights faded in the distance. I parked and laid down on the dirt. Stars littered the sky like pieces of shattered glass. I thought of the anguished bereaved like Brad, floating alone in the dark, burdened by the weight of unimaginable loss, robbed of the rituals we have historically relied on to give meaning to grief.
A shooting star tore across the sky. When its light disappeared, my eyes focused on a star. It was Sirius. The chaos of the stars began to take shape. I no longer saw stars but instead Cetus, Cassiopeia, Andromeda. Suddenly the sky was a history of tragedies, triumphs, and losses.
This year left many in the dark, struggling to make sense of senseless loss. We may feel alone in our grief, but we are part of a bigger constellation. To look at the night sky and see stories, to create meaning and myth out of the pieces of our shattered lives, and to know in that ancient way of knowing that our loneliness is shared is what it is to be human. This collective hardship allows us to defy the distance between us and look into the eyes of a stranger and feel the thread of our inexplicable bond. It is not easy, but it is what these times demand. So, as we stand alone looking upward and find ourselves confronted by the darkness of the night sky and the chaos of the stars, what will we choose to see?
2021 Hope Babette Tang Humanism in Healthcare Essay Contest
The Arnold P. Gold Foundation holds an annual essay contest to encourage medical and nursing students to reflect on their experiences and engage in narrative writing. The contest began in 1999 open to medical students and expanded in 2018 to include nursing students. Students are asked to respond to a specific prompt in a 1,000-word essay.
For the 2021 contest, students were asked to use the following quote as inspiration to reflect on humanism in health care during the past difficult year using their experiences or observations, as an individual or as a team (doctors, nurses, therapists, etc.)
“We’ll observe how the burdens braved by humankind
Are also the moments that make us humans kind;
Let each morning find us courageous, brought closer;
Heeding the light before the fight is over.
When this ends, we’ll smile sweetly, finally seeing
In testing times, we became the best of beings.”
—Excerpt from “The Miracle of Morning,” by Amanda Gorman
More than 270 essays were submitted. A distinguished panel of judges, including esteemed health care professionals and notable authors, reviewed the submissions. Three winning essays from medical students and three winning essays from nursing students were selected, along with 9 honorable mentions. The winning essays will be published in consecutive issues of Academic Medicine and the Journal of Professional Nursing in the fall/winter of 2021.
The contest is named for Hope Babette Tang-Goodwin, MD, who was an assistant professor of pediatrics. Her approach to medicine combined a boundless enthusiasm for her work, intellectual rigor, and deep compassion for her patients. She was an exemplar of humanism in medicine.
The Arnold P. Gold Foundation is a nonprofit organization that champions humanism in health care, defined as compassionate, collaborative, and scientifically excellent care. This Gold standard of care embraces all and targets barriers to such care. The Gold Foundation empowers experts, learners, and leaders to together create systems and cultures that support humanistic care for all.