Saturday, July 16, 2011

A story to teach us

Breakfast In Bed

A story to teach how one might respond when death is near

I get out of the car, grab my blood pressure cuff and sack lunch and head for the door. There is a moment I want to run home, puff up my pillow and go to sleep. But the door opens quicker than my resistance.

“I’m Patrick, Come on in.”

He has a Rock Hudson smile. Looks like he should be wearing a Letterman sweater and chunky class ring.

I leave fear at the door, step into my nurse role and follow to Ray’s room. It is not a bedroom, probably never was, but a room off the kitchen, open to the California sun and bird song in the garden. In my minds eye I could see an older couple, though neither would have thought themselves so, sharing morning coffee and the New York Times, then later Scrabble and intimate talk into the night.

Now it is a hospital bed exactly in the middle of the room looking out to the private garden. Ray does not open his eyes to the tiny lights glittering about the garden wall with ferns curling in moist dark air and fountain lifting up and falling back like water pebbles into a marble dish. The summer night is warm with the double glass doors open to the fragrance of night bloomers and hillside sage.

Ray’s wife leans heavy into a chair that had once been elegant, spring green and velvety. The chair and the woman’s shoulders sag ever so slightly. Her body tells me she has little time or interest to eat. The bed rail is down, the chair tight against the iron bed enabling her to be close with her husband.

The lighting is soft on Ray’s world, an afghan folded at the end of the bed and a small curly dog sleeping on the smooth sheet. In the far corner there is a crystal vase of sunshine yellow roses mixed with sprigs of baby’s breath.

“There is so much life in this room,” I breathe out quickly.

Ray does not stir.

Mrs. Levine corrects me, “That is love, Cassandra, it is love.”

She tells me to call her Jean.

My eyes follow her arm on the narrow bed, Jean’s palm down on the bedding as she supports her husband’s hand on the back of hers. A gentle way for him to know she is there and feel her love. I feel a quivery flutter in my chest seeing this woman of the heart helping to shoulder her husband’s burden. Jean holds the light, gentles his spirit and helps ready him for his leaving. I can almost see the land of the stars above.

I lean near and note Ray’s heart taps blood close to the surface of the sunken part of his temple, the hard edge of bone at the boundary. A bag hangs under the bed. Not enough red clear liquid to measure. A hand knitted cashmere cap slips a little too loose to his eye brows.

There is none of usual hospital equipment, syringes, bottles of saline or ripped open plastic wrappings. Mounds of linen gone, both clean and folded, and the dirty.

Patrick takes Jean’s place and we go to the room across the front of the house, brocade drawn over windows, a couch of icy blue velvet, chairs, stripped silk. There are no pillows. I have a feeling even the paintings are dust free.

Jean sits erect, barely supported by the stout chair. I am grateful to sit down. She tells me of her husband’s Washington days, 6am to near midnight. She talks but her mouth is protective, the sound and breath of her speech barely escaping.

“With my husband’s desperate diagnosis we had to return home. ”

She continues about the years in DC and of his friend.

“Ray’s best friend was the Minority Whip in the House.”

I know who she speaks of, died a couple of weeks ago, a long time survivor of politics and powerful presence in Congress. The death shocked Washington.

Jean looks to the bare floor surrounding the oriental rug, then with a certain kind of brightness,

“Such a sudden death. I had a quick thought he had gone on ahead, to help Ray in his passing. ”

There is much she has to say but the inevitability of sleep presses into the conversation. But she continues on about the team she’s organized. There is the cook, housekeeper and we, nurses. Patrick oversees everything, is a listening ear and occasionally sleeps. Sleep is not a part of any ones’ life here. Except for Ray who has not stirred for several days.

The following night Jean dozes in the chair, sometimes she puts her head down next his. His breath now heavier, rhythmic. Around 3 he stirs. I raise the head of his bed a little more to relieve his back and enable breath to come easier. Patrick hears us and comes out. Ray jolts awake, looks to me, then to Jean and in a not so sound asleep voice says,

“I want breakfast.”

This non responsive man who hasn’t even moaned for 2 days, has been without food or water for a longer time, now with eyes wide open he repeats,

“I want breakfast.”

Patrick is firm but with tenderness,

“It is not safe for him to eat, he might choke.”

They look to me, the new nurse on the night shift. They wait. I am here as an “expert”. A Registered Nurse who does not respond. Within the quiet place of myself, I have a private conversation within myself, “Patrick is right but it is not a bad way to go with eggs and bacon and happiness with the taste and smell of toast and jam.” “Heaven forbid that I say such a thing. And as a professional, responsible.”

I quick glance at the fountain in the garden splashing in the marble bowl.

The thoughts continue to flash in micro seconds about the realities of this time of life, “The body does not need food or even water. It is shutting down. Not able to process food, water or even ice chips. ” I muse how families worry but it is the way of the body when it can no longer can support life.

The words hang out in my brain with memories along with conflicting considerations, when Jean says with the same force she had used the night before about the room being full of love,

“If the man of the house wants breakfast he shall have it.”
The cook is awakened, frying pan brought to the fire, eggs cracked, bacon fried to crispy edges, orange juice poured and sweet butter spread down into warm toast and cut into triangles. Small amounts of each are arranged on a dessert plate of bone china. The cook pours several swallows of very hot coffee into a translucent tea cup. I think of sweet tenderness as Jean places the breakfast on a silver tray, adds a pressed linen napkin and a rose bud and takes it to her husband. She puts it on the lap table before him. He looks down then up to Jean, his eyes spark blue, the twinkle she has always loved. With a small spoon, roses on the handle, she takes several bits of crumpled bacon, mashes it into the scant portion of scrambled eggs, puts it to his waiting mouth, and almost like a baby bird he takes it in, closes his mouth and chews, or rather mouths it for what seems like a very long time. We three stand close and beam like happy bird mothers. When he is finished a linen cloth is offered. He lets it go into the napkin and leans deeper into the pillow, looks up to Jean and smiles.

NOTE to you: This experience of Jean and Ray is a powerful experience that taught me about love and beauty, weariness and support, and how one woman redefined what could be done at the close of life. I invite you to think about them and let us come back together to "talk" about it. What moved you, helped you, gave you ideas? How did the writer let you know death was very near? What has been your experience that can teach us about how to be there? Sincerely and in support of you, Cassandra Christenson