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“Today is my day” Death as a Miracle by Allison Gray, RN, MSN

Sunday, 26 Feb 2012 21:35

About Dr. Monica Williams-Murphy (120 Posts)

Dr. Monica Williams-Murphy is a Board Certified Emergency Medicine Physician, who practices in one of the largest emergency departments in the United States at Huntsville Hospital. Through her writing and speaking, she is devoted to transforming the end of life into a time of peace, closure and healing. Media Page


I have been an ICU and ER nurse for 16 years and during this time I have seen very few, if any patients or family members that have been “prepared” to die.  I have seen a lot of miracles that have kept people alive, but never have viewed a death as a miracle, until the case of “Mrs. Elizabeth”.

***

I am often described as a sassy, confident, lip-gloss wearing trauma nurse who does not mind “telling it like it is” or stating my opinion.  When I am doing my job critical or not, I am very focused and serious and feel that I have to hold back my emotions to provide the best care for my patient. This said, my co-workers are shocked when I get upset over a patient or when I become gentle and sweet because I am moved by a patient experience.

I recently had such a patient experience with an elderly lady. I gave her my most gentle care and she gave me a revelation regarding death and acceptance.  Her name was “Mrs. Elizabeth.” She was pale, but beautiful, her hair perfectly rolled and styled, and was wearing bright pink “granny lipstick.”

She had come to the ER with vague symptoms of right sided breast/chest pain and pain in her neck with movement.  Her initial blood pressure was low at 75/45. There were several of us “experienced” nurses in the room and we had several possible diagnoses and plans of action based on her presentation. Once a heart attack was ruled out, we thought about an aneurysm.

She continued to talk as we hurriedly placed her on monitors; placed IV’s and drew her blood for testing. Our initial nursing assessment consists of numerous questions regarding a patient’s history, lifestyle and the newest question is: “In an emergency situation would you want us to give you blood or blood products to save your life?”

“Mrs. Elizabeth” quickly responded, “NO.  If God wants me he can take me when he is ready, because I am ready.”

Again, I explained to her what this would mean and again she stated, “No”.

After completing our initial documentation and stabilizing her blood pressure, she was placed on a portable monitor for transport to Cat Scan (CT). We moved her over to the CT table and explained to what would be occurring. We reassured her that she would remain on the monitor and both of us nurses would be behind the glass watching her as she was being scanned.

The scans began, and by NO means am I any type of expert in reading radiology films, but I KNOW when something is ABSOLUTELY abnormal. Her CT scan was ABSOLUTELY and obviously, a Cardiothoracic Surgeon’s worst nightmare!

She had multiple aneurysms leaking into her neck…

One of the radiologist, who just happened be in the CT room with us, glanced over at the screen displaying her images and said “WHAT the **** is that?” (He happens to be one of the most amazing physicians I have ever encountered and has saved my own father’s life multiple times.) The fact that he was dumbfounded by her cat scan sent chills down my spine and our heart’s dropped for “Mrs. Elizabeth.”

We carefully moved her back onto her stretcher and proceeded back to the ER, where she was placed in one of our “critical beds,” as we knew now that she had a life-threatening problem; and, I have seen patients that have a Do Not Resuscitate order in place or who make statements like she did earlier regarding their wishes but then in desperation, change their minds and want “everything possible done to save their life.”

I guess selfishly I wanted that for “Mrs.Elizabeth,” too.  I had just returned the day before from spending time with my 90 year-old MaMaw, in Mississippi, whom I adore and am so close to.  We lost my Papaw a little over 1 year ago at age 90 and I had never really gotten over it.  I think most nurses are viewed as “the strong ones” in their families…I had to be strong for my MaMaw and my mother, who had lost their husband and father.  With my aging MaMaw and the passing of my PaPaw on my mind, I continued to swallow lump after lump in my throat as we prepared for her family to arrive.

The ER MD made multiple calls to make sure this patient would be taken care of; then, he came in and told her what the scans revealed. He is younger MD and used “medical terms” and words that most would not have understood. As he left the room, I “re-explained” it to her and “re-verified” that she was lucid enough to make a clear decision for herself…. and, THAT SHE WAS.

In the presence of myself, 2 other nurses and our amazing patient family representative, Penny, “Mrs. Elizabeth” stated, “I don’t want any surgery or any blood.  If it is my time, I am ready to go.”

As I swallowed another lump in my throat, and fought back tears, I answered, “Yes ma’am.”

I was thinking to myself, “How brave but stoic she is… and how amazingly strong her faith is, and that she is able to place all of her trust in God.”

Just then, her daughter then entered the room followed by her granddaughter, who was approximately 35 years-old (near my own age) and a RN in a nearby hospital.  As I explained to them what was about to happen, I watched closely as this granddaughter-nurse “held it together” for her mom and her grandmother, just like I had done for my own family. Suddenly, I realized that I was reliving my experience with my own family through “Mrs. Elizabeth” and hers.

Just then, the Cardiothoracic Surgeon came into the room.  He explained to “Mrs. Elizabeth” and her family that he, “May or may not be able to surgically repair this.”

She replied, “It doesn’t matter. I don’t want any surgery. Today is my day. I am ready to die.”

Speechless… he then mumbled, “What can I do for you?” She replied, “Just give me a shot to ease this pain. I don’t want to suffer.”

With the blood leaking into her neck, her neck began to swell and eventually, this would make it uncomfortable for her to even breathe or speak. We kept her comfortable with pain medications as we stayed in the room with her to comfort her and her family, but somehow it was “Mrs. Elizabeth” who gave us comfort.

She told her family that she had just changed the linens on her bed at home. She told them that the key was under the flower pot on the door step, and gave them other directions. She actually had a previously scheduled check-up with her cardiologist that day- she asked her daughter to call his office and apologize that she would be unable to keep that appointment. She said, “Tell them that now I have an appointment with God.”

She began to become less responsive as her vital signs decreased, and yet she stated weakly, “My lips are dry and I need some lipstick.” It had been wiped away by kisses she been giving her family.

They scurried to look for lipstick but could not find any,  so I reached in my pocket and pulled out the lip-gloss that I always carry and began to cry as I tried to squirt some onto her granddaughters finger to place on her grandmother’s lips.

About the same time the daughter found “Mrs. Elizabeth’s” own “bright pink” lipstick and placed it on her. She smiled and looked somewhat relieved even as she began to moan in pain.  In addition to her lipstick, we gave her more medication for comfort.

Her family explained to us how she was very neat and organized, and always stated she never wanted to be a burden to anyone. Once again, the “selfish me” came out and said “Is that why you don’t want the surgery,’Mrs. Elizabeth?’ So you won’t be a burden to your family?  They love you, and would happily take care of you, just as you have always taken care of them.” I knew that I was asking her this as a last ditch effort to keep her family from feeling the hurt that I felt with the passing of my own PaPaw. Yet, in reality, nothing we can do prevents death, we can only delay it.

Very peacefully, but matter-of-factly, “Mrs. Elizabeth” said, “No. I don’t want the surgery because I am ready to die, TODAY.”

As we stayed by her side, talking about her life, she drifted off into an unconscious state. We were also waiting for a last family member to arrive, her brother.

Minutes later, he walked in the room and then she peacefully passed away– with all of her family holding her hands, lipstick on, ready to meet her God.

We all stood together with tears streaming down our faces. It was AMAZING and BEAUTIFUL, YET GUT WRENCHING all at once.

Her brother then turned to his niece and stated, “Do you know what today is?” She said, “Oh MY GOD!” then the granddaughter ran into the hallway crying.

“Mrs. Elizabeth’s” husband had died 25 years ago on the same day of a massive heart attack.

Suddenly, it all became clear….She left this earth on the same day her one true love did…25 years later. She was right, “Today was her day.” It was her day to die.

***

“Mrs. Elizabeth’s” death was a miracle for her and for all of us who witnessed it:

-She was PREPARED.

-She PREPARED her family.

-She taught us all that it is “OK to die.”

– I believe that this was also a miracle for me. I don’t believe that I was the nurse for this family and this patient by accident. They needed me and I needed them. Was Papaw somehow letting me know that because of his amazingly strong faith that he, too, had been prepared for death?  Was he asking me to accept his passing? I think so.

As odd as it sounds, and myself once a “non-believer in preparing for death”… Death can be beautiful when prepared for regardless of the circumstances leading to it.

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