“Are you crazy? She’s terminal.”
“I don’t care. Get him here,” I ordered the two nurses in the room.
The nurse from the Maternity Ward stepped out.
“He’s on his way,” she said when she came back a few minutes later.
The patient’s condition was stable: fast, regular pulse; BP 55 over 85. But I felt something wasn’t right. I stayed by her.
“What happened?” the on-call asked as he entered.
“Something’s going on. Her blood pressure dropped, she had a supraventricular arrhythmia that responded to isoproterenol, then she had involuntary limb movements. We tied down the IV arm.”
“She’s bleeding,” he said after examining her.
“From where?”
“I’m not sure – maybe the intestines…”
Before he could finish the sentence a jet of black vomit erupted from her mouth like a fountain.
“She’s bleeding into the stomach.”
“Order blood?” the nurse asked as she wiped her face.
“Yes. And call in the lab on-call immediately.”
Just a few hours earlier Aaron had told me she was terminaland not to call the on-call – yet now the on-call was preparing to make every effort to resuscitate her.
For what – just to extend her suffering? I thought.
“We have to do everything to keep her alive,” he said – apparently reading my mind.
“I know – and I think you’re right,” I said, backing his lead.
I watched him keep trying everything to save her.
“Run saline wide open so we can maintain BP until the blood gets here,” he ordered.
I opened the IV roller clamp. The flow roared. Her pressure kept falling and the rhythm again turned fast and wildly irregular. Suddenly, without warning, a flat line appeared on the monitor. She lay motionless. Instinctively I climbed onto the bed and began chest compressions. I felt her ribs give under my hands – some surely cracked. Whenever I stopped pressing, the monitor line went flat again. I was failing at compressions, but there was one last chance: electric shock.
Only when I heard the defibrillator had arrived and was ready did I jump down. Even five shocks one after another didn’t help.
“That’s it – she’s gone,” he said. The screen showed a flat line. “I’ll go tell the family.” I followed him, stunned. It had happened so fast.
“She passed away. I’m sorry,” he told the two men, who had already understood from our faces what had happened.
“I’m sorry,” I said to them as well – the brother and his friend. The brother took it with restraint, at least while the department head and I stood there. Only when we stepped away did I hear him cry.
When I came back a while later, I heard the brother say, “The Lord gave and the Lord has taken away; blessed be the name of the Lord.”
“Amen,” I said. “May her memory be a blessing.”
The images of the patient in her final moments – and after –and her brother’s noble bearing accompany me to this day. Not infrequently, they blend with my own personal memories.
Death is, obviously, a mysterious matter, and people’s reactions to it vary widely. Some express themselves with extraordinary intensity – not only crying or shouting, but sometimes even climbing into the deceased’s bed, hoping that maybe, just maybe, life will return for a moment. Yes – for a fleeting moment. The sense of a person’s sudden disappearance is inconceivable. Often, I also ponder the verse “The Lord gave and the Lord has taken; blessed be the name of the Lord,” and I can’t grasp its meaning. I can’t accept that the reasons for death, when it comes, are known only to God.
Chapter 41
