When I was working in the cancer ward, death was almost a constant presence. In the dialysis unit, where I have worked over the last fifteen or more years it lurks in the background, making its existence felt periodically. On occasion it looks right into my eyes.
It was on a routine Monday morning that my Manager informed me that “a patient has coded in the North clinic and you need to go there.”
Within a couple of minutes I turned off my computer, piled the sheets of papers on my desk and informed the charge nurse as I grabbed my bag and headed to the other clinic. Twenty minutes later I encountered the Sheriff’s deputy talking to Mrs. P. in the parking lot.
Mrs P hugged me tightly as she said, “He went peacefully. Everyone did the best they could—I am so relieved it happened here.”
Her daughter Mila was in the car. She stepped out with tears flowing down her cheeks, one hand holding the cell phone to her ear informing her sister of the recent demise. She embraced me with her free arm, reiterating Mrs. P’s words.
Encountering death is always painful and this happened right on the unit, amongst so many patients, surrounded by a slew of health care workers, who nevertheless had to keep up the appearance of normalcy as they worked in unison to deal with a loss.
After a quick briefing by the law enforcement officer I stepped into the dialsysis clinic and approached the patients to see how they had been affected by the recent events. The patients expressed praise and admiration for the nurses who had been quick to take action and for the dialysis technicians for their presence of mind.
These patients—men and women, deal with the possibility of death each day. They come for treatment daily, knowing that without dialysis they could not possibly survive. Yet almost all of them are living as full a life as possible.
Some are still working, many have retired but continue to have a very active social routine.
Yes, there are a great number who have slowed down, at times even almost totally incapacitated, by the numerous health problems they are experiencing.
On a day when they closely witness what could well have happened to them they are full of gratitude and appreciation for the staff on duty. The staff are tremendously thankful that the patients recognize the life-saving tasks that are constantly being performed, as they scurry around starting catheters or getting the needle stuck precisely, just so a relatively comfortable treatment can be initiated.
As I reassured each patient and gauged their emotional state I also needed to offer support to all those workers who had to keep the schedule moving, with no interruptions in any treatment.
Amidst all this, the presence of the body, now moved to a private room, could be tangibly felt by everyone in the clinic. A death in the community, as this incident would be defined, automatically becomes a Coroner’s case. The deputy had filed his report after questioning the staff members involved. He asked me about the family, whether the patient had a DNR (do not resuscitate) authorization and about the over all health of the patient. All the paper formalities were carefully attended to.
Since there was no indication of any foul play the family was instructed to arrange the pick-up of the body.
As the staff discussed the events of the day several had begun asking if we as caregivers had done all we could and if any process could have been handled differently.
The vote of confidence that we received from the family as well as the law enforcement personnel reassured us that we had risen to the occasion and done the best we could. That is as good as it gets.
Yes, in many ways it was a beautiful death. The pain and anguish that the family had been fearful of confronting, with their loved one passing on, had been averted. The patient had expired while being cared for by the staff who had become his health-care family over the last six years.
Imminent death always exists in our clinics, occasionally it happens uneventfully in the home, especially if end-of-life issues have been addressed in a timely manner.
But today the drama had occurred in the midst of a full house. It was theater at its best, with each actor giving a star performance. No I have no intention of romanticizing the last act but events like this make me realize that though each one of us has only a minor role, it is significant enough. Our roles and jobs must be performed to the best of our ability.
People often ask if I get depressed or if the seriousness of the matter drains my spirit. The answer is yes it does, but it also helps me gain some perspective.
I may not take life lightly but I certainly have learnt how to make light of it. Maybe that is why the inevitable becomes beautiful too.
Latika Mangrulkar is a story teller, social worker, and educator. LM writes and presents in 3 languages. Her stories, poetry and workshops have been featured in diverse cultural and academic settings across borders.