Then she begins to speak in that language nurses have, a language of abbreviations, diseases and curses. She tells him, or maybe she is not telling him at all, she is telling herself.
“And the resident wouldn’t call his fellow. And I think that’s…that’s because he realized before I did that this woman was just going to die.” She shudders silently. “And she did die.”
“People die there all the time, right?”
She makes a funny noise. “People die all the time in the ICU, but this woman got to me! Her dad was there, sitting in the corner, and he just looked so lost, and her sister was walking up and down in the hallway muttering the F-word. And then I realized everything we were doing was pointless.”
She laughs, a terrible sound. “We knew she would die, but we couldn’t say that to the family. Why? Why couldn’t we say, we know she is going to die no matter what we do?” She laughs again, but he can hear that she is not smiling.
“So they decided to put in a chest tube, but the surgeon that comes just dicks around for the longest time, she can’t decide whether it will hurt or harm the patient. And I took the sister out of the room, explained what was happening, asked if she knew what her sister’s wishes were, and she finally started crying and said, ‘We were supposed to go to Florida together.’”
In his mind’s eye, he sees a 40-something woman sitting on the beach. The sun is bright and hollow. The chair next to her is empty.
“I don’t know how we bear it. I usually don’t get like this with families. I usually see a patient in the bed, disconnected from everything, and that is okay…. But we were working so hard, and we finally knew it was pointless and when I looked at her sister…and I saw that unbelief. She had had so much hope!”
There is silence. He holds her tighter, thinking of what he could lose. Outside, the wind blows through empty branches and the moon watches the world silently, dispassionately. Outside of the room, there are dirty dishes and unpaid bills. There is a snow blower that needs to be serviced and a mother-in-law who hasn’t been visited in weeks. There are drafts unfinished, unhappy clients and traffic jams waiting to happen. There are wars and famines and plagues and droughts, but in here, in this room, in this bed, there is her, alive and sobbing.
“I love you,” he says, and realizing that he means it, kisses her hair. She cries some more, and he lets her, thinking about non-Hodgkin’s lymphoma.
After a few minutes, she quiets. “Do you feel better now?”
“Kind of snotty, but better.” She sniffs. “If you let that stuff build up inside, you rot, I think. It just sits there, and you rot.” She gets up again and goes into the bathroom. This time, she turns on the light. “I’m a freaking mess.” The door shuts and he hears water running and then she comes out again.
“Sorry I had to put you through all that,” she says, and in the light of the bathroom, she casually strips and then kills the light. He is temporarily blinded and also rendered mute by her outpouring. But to her, it must be in the past. She is crawling across the bed, to kiss him, to lay her body, beneath the blankets, on his.
Cortney Davis, CFCP
How I’m Able to Love
I’m stunned by death’s absence,
by the flesh that remains, changed and yet hardly so.
I try to pretend the body’s a pod or insect shell,
but attending the body after death
I see the body with all its attributions
for the first time, totally honest—
a time to satisfy that final curiosity,
the long gaze that reveals a life compressed, unalterable.
Beyond the window, rain falls. Streets below
shine like an untied black ribbon.
When my mother died, I was the one
part nurse, part daughter. I caught her last heartbeat
with my fingertips, knowing that the lungs
fail a few beats after, then breath empties them.
From long experience, I stood at the moment
just before and stroked her hair
as life moved through her as it always does—
pulling itself up through the ankles
through the bruised aorta
taking the heartbeat along, gathering the last
lungful of air and leaving nothing, all this
up through the jaw and, at the moment life breaks free,
out the open eyes. The hands respond,
as if the body wasn’t robbed, but had been clinging and let go.
I don’t believe in death.
Even when the body mottles, even
in its closed casket, I see the body I have touched,
staring at it as I work. Only my fingers
retain the memory
of my memory. This compression is good:
it makes room for all the dead I know and don’t know —
the familiar dead and the dead yet to be born.
“How I’m Able to Love” originally appeared in Cortney Davis’s Leopold’s Maneuvers (University of Nebraska Press), winner of the Prairie Schooner Poetry Award and an American Journal of Nursing Book of the Year Award.
Ayelet Amittay, BA, MFA, MSN
Looking Glass Counseling Program
Even his blood is against him. It clumps together like kids in his second grade class, the ones who make fun of his trips to the nurse’s office. It blocks off vessels, leaving no room for air. Today the pain hits him in the chest like a bully, and he’s back on the peds floor again, where all the nurses know his name. Another crisis? the blonde one asks. The colors on the peds floor are bright, and there are a million toys to play with. He is unimpressed. The pain grates on his brain, and he wants the lights off, then on again. He wails. Aides rush in with breathy concern, check the morphine drip, ply him with popsicles. But he’s had enough hands on him today. When his mother teases him about how rude he was to the doctor, he starts to bawl, one eye on me to see what I’ll do. Just try to come near me—I dare you.
I think of his blood, its sickle shapes locking together, squeezing out the air. I want to give him an airy dome, an astronaut’s helmet, nothing but cold clear air easing into his lungs. I want clean and quiet, not this beeping morphine monitor, not the constant inquiry of stethoscopes and pain scales. Without thinking, I say, let’s cover you with the sheet. He doesn’t object, so I gather the sheet he’s kicked off and cast it over him, like a net. Like an invisibility cloak. Like snow covering burnt, hard ground.
A white lump. His sobs grow softer. This is your igloo, I say. No one can come in without you saying so. He stops crying. You let us know, I say, when we can come visit you, igloo man.
A few minutes pass. You can come in now, he says. I poke my head under the sheet.
What a beautiful igloo, I say. Such nice cold air. Take a deep breath.
He does. He shows me around the igloo: his pet polar bear, his swimming pool, his gymnasium, his flat-screen TV. He decides to visit the outside world. If it gets too hot, we agree, he can always go back to the igloo again.
On his hospital room TV, Spongebob Squarepants has wished himself normal, and the wish has come true. Spongebob is round, with no holes, no buckteeth. Look how funny he looks, he says.
Normal looks funny sometimes, I say.
He doesn’t say anything, but when Spongebob’s buckteeth come back, he smiles. At his temple, I can see the steady pulse, the blood beating.
Copyright 2010. Igloo by Ayelet Amittay, was originally published in Critical Care Nurse. 2010; 30(4):74. Reprinted with permission.
Stacy Nigliazzo, RN
Emergency Department, Physicans Centre Hospital
I see myself, always
through a stark looking glass
the fun house view of my own face
reflected in the eyes of my patients—
tangled in the bleeding strands
that line the gray sclera of the meth addict
drowning in the pooling ink that splits
the swelling pupil of the hemorrhagic stroke
swimming in the antibiotic veil
that blurs the newborn’s first gaze
My clouded countenance,
slipping even through parched flesh
along the steely glide of the angiocath
glistening in the acrid snap
of intravenous medication
from the bleach-wrung siderail.
Twelve hours streaming from my skin
like an open wound in the scrub sink
face to face
in the soap-splattered mirror—
do I look away
Read more of Stacy Nagliazzo’s poetry in her new book, Scissored Moon (Press 53).