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The Art of Medicine

The source of your strength

Maurer, Brian T. PA-C

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Journal of the American Academy of Physician Assistants: December 2016 - Volume 29 - Issue 12 - p 68
doi: 10.1097/01.JAA.0000508211.34837.2e
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She appears in the hallway outside the laboratory, spray bottle in hand. Dressed in hospital scrubs, she's just arrived for the evening shift, while I'm zipping up my coat to go home.

“How are you doing?” I ask, digging in the deep pockets for my gloves. Although it's been over a week since I heard the news, I'd only seen her in passing—no time to talk until now.

“I'm okay,” she says. “Really, I'm okay.”

“I heard he didn't linger,” I say.

“That's right. I spoke to him the day before. He sounded upbeat. Told me he'd made himself a peanut butter and jelly sandwich for lunch; asked if I'd come over and sit with him. I told him I'd be over later that afternoon.”

She fiddles with the plastic spray bottle, drops it on a nearby counter and folds her arms across her chest.

“I took my daughter with me—she stayed home from school that day with a bellyache. We walked up the stairs and down the hall together. When I saw his legs sticking out from under the covers on the bed through the open doorway, I knew. I sent my daughter back downstairs to the den.”

She drops her arms by her side and looks down at the floor.

“He was lying on his side facing the far window. I saw the pool of blood on the pillow that had drained from his mouth; I could hear the gurgling sounds coming from his throat.”

Her eyes come up to meet mine and start to water. Her voice has dropped to a hoarse whisper.

“I called him—‘Dad,’ I said, ‘Daddy’—but he didn't respond. I slid my arm under his shoulder, tried to roll him back, tried to raise his head on the pillow, but he was dead weight.

“I called my brother's cell phone, but he didn't pick up. I dialed his work number and told him he needed to come over right then. He didn't want to leave, but I told him he had to. When he got there we managed to pull my dad up on the pillow, but he was still gurgling every time he breathed.

“When the hospice nurse showed up, she said, ‘When did he have the stroke?’ For the first time I looked at his body, saw his whole left side cramped up. It was so obvious—how could I have missed that?

“She showed us how to turn him to make him more comfortable; then we cleaned him up a bit. I took my daughter home, got cleaned up, and went back that evening.

“I sat by the bed, held his hand. It was a high bed, so I had to really reach out. The hospice nurse said it was okay if I wanted to lie down next to him, so I did. I told him all sorts of things that night—told him I loved him, told him it was okay for him to go, told him my mother was waiting for him to come over so they could go for a long walk down the beach together.

“My husband brought the kids by the next morning. We were all there with him at the end. It's hard to watch a person breathe like that”—she lifts a hand to her chest—“I don't know what you call it—”

“Cheyne-Stoking,” I said.

“That's it, Cheyne-Stoking,” she said. “The hospice nurse said it was okay at that point. She had given him some morphine. He finally gave in. It was somewhere around 1:30 p.m.”

A solitary tear falls down her cheek.

“I let my kids say goodbye to him. They were both pretty broken up. It was tough—they had seen my mother die a year ago—but I had peace about it, thought it was the right thing to do.”

“So how are you doing?” I ask her again.

“I'm okay,” she says. “I have my moments. Death is a horrible thing—just horrible—but I know he's at peace. I did the best I could.”

“Of course you did,” I say, wiping the fogged lenses of my glasses. “You did an excellent job.”

“Here,” I say, turning back to grasp the small slip of paper wedged in the frame of a black and white photograph on my desk. I glance at it in my hand and offer it to her. “This is for you.”

She takes the tiny slip of paper and reads the words.

“I saved it from lunch at a Chinese restaurant a while back,” I say. “At the time I didn't know why or who it was for—until now.”

She reads the words again: “Meeting adversity well is the source of your strength.”

“That's you, all right,” I say.

Her face lights up like a clear morning after rain in springtime.

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