Timing is Everything

An interesting labor day weekend, as I worked all three days.  Yesterday was one of those, “Can’t believe this is happening” days.

I worked in the hospice house and was taking care of a 70ish gentleman who had just been admitted the night before. He had metastatic prostate cancer and had been deteriorating rapidly at home.  The family all arrived in the morning, and were surprised to see how much closer to death he was.  He wasn’t opening his eyes or talking, he had that sound with each breath of a rattle of fluid stuck in his throat. His wife of 50 years was having the hardest time, saying things with a tinge of anger because of how quick this was all happening.  I had spent time with the family talking about all that was happening, and let them know we were expecting him to go in hours to a day at most.

I was out working on other charts when a family member from this room came running up shouting, “My mom has just passed out, come quick”  I entered the room to find the pt’s wife slumped in a chair, looking very pale, having just come to.  Everyone appropriately swooned over her. Her blood pressure was elevated at 220/100 and one of the nurses told her, “You need to go to the ER, with your blood pressure so high, you could have a stroke”.  The family started echoing this advice and all were a bit panicky.

I was standing by the husband’s bed watching as everyone forgot about the him and hovered now by the wife.  I glanced down at my patient, and noticed his breathing had changed, a long long pause and then a very shallow breath. He was dying, right then, and everyone had forgotten about him. They were all debating about taking the wife to the ER, and she kept shouting, “No, I want to stay here!”  I finally interrupted, “Mrs B, I think you should stay, you should also take your husband’s hand now, because it won’t be long”.  Everyone’s head’s whipped around and had that wide-eyed look.  A daughter looked at me, then at her father, “You mean he’s dying?”  I nodded my head and the swarm moved back around the patient’s bed.  The stress and emotions of having their mother just pass out, and now moments later having their father dying was too much.  Loud wailing and sobs filled the room as I watched him take his last breath.

How ironic for his wife to have passed out, literally minutes before he died, as if his soul leaving somehow sapped some of hers away. And they had almost missed it. He almost slipped away with everyone in the room, and yet not one person’s eye’s on him.   Maybe that’s what he had wanted.

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