The room facing the city

I used to know the count of the number of individuals that I have seen die. Before I was a nurse the only dead people I had seen were my grandparents in their caskets and despite my parents prodding, I had never actually touched a dead person. Don't get me wrong, there are worse things than death, but few Americans have actually been with another individual while they are dying. It's interesting to see what happens to the body as it shuts down. Horrid to say- but it is really fascinating to see what happens when it is an emergent situation. You can watch the electrical activity of the heart with those green lines and monitors are blaring at you because the algorithm has determined that you are in deep shit. Lungs collapsing, tubes being inserted, veins being probed and pumped full of fluids. Blood pressure dropping, orders being given, medications being mixed and pushed violently in catheters. "Stand clear," electricity pulses through the body, as the chest heaves into the air. Epi, atropine, ABGs, Fluids wide open, "when was the last epi given?" "Turn the paddles to 360." "All clear?" The heart is always the last thing to give up...


In my new unit I do not participate in as many code situations. People in a neurosurgical intensive care unit are relatively healthy. Those who are not, don't live through the assault to their brain. They just die. However, I still see the struggle of the heart in my unit. There is a patient in one of our rooms, who has been here for 97 days. She lies in her bed with perfectly straight sheets, facing the Chicago skyline. Her position is adjusted hourly. The white tube from her right nostril provides nutrition. There is a drain coming from the left side of her brain and a dressing on the right, where the other drain had been last week. Her heart rate, breathing, body fluids, and mental status are monitored hourly. Occasionally she will move her arms, but never to command and I have never seen her eyes open. Her condition is deteriorating daily and new tubes and gadgets are frequently added to her care.

Daily, an older gentleman comes to her bedside. They almost have the same color of gray hair, except most of hers has been shaved off for surgery. He strokes the small patch of hair left at the nape of her neck, when she is positioned on her right side. Frequently, I walk pass the room and his chin is resting on his arm, which perched on the upper side rail of the bed- at a 30 degree angle to prevent his wife from choking on her own secretions. His other hand is always placed in hers.

I wish I was able to photograph this couple, as it is difficult to describe the expression on his face. He looks at her longingly, knowing she is dying. You can see the adoration in his eyes and know he aches to have one last look into her eyes. To tell her thank you and that he has appreciated their time together. He desires to tell her that he loves her and that she should go, but he is horrified at how life will be without her. I look at them knowing that when she goes, he will follow. You can walk past the room and see that their love is deep, true, and strong. They had the love that is told of in stories and is dreamt about by little girls. The electrodes continue to monitor brainwaves, the urine drips into the catheter, and he sits for hours, silently holding her hand. Like I said, the heart is always last to give up.