The First One Stays

Anyone who has been in nursing for a little while has had to deal with death.  We have a front seat to it, so to speak. Surprisingly for me, it isn't as hard as I thought it would be.  It becomes strangely normal.  Wash the body, zip up the bag, fill out the paperwork, make the phone calls, return to your day.  Besides the unusual or unexpected cases, it starts to not really phase you all that much.  But the first one, that first patient you lose, stays with you for a long time.

  I was working on a medical floor at the time, that first painful year of nursing. The hospital I worked at was in a town that was split down the middle between college students and retirees.  I'm sure you can guess which one made up 99% of our patient population.  We got to know many people fairly well, as many of the retirees made their way to the telemetry unit several times a year.

He was a little old man who hadn't lost his spunk and spirit.  The first time he was my patient he couldn't wait to get back to his nursing home because there was a lady there he had been seeing.  He talked long and passionately about her and about fishing.  I remember thinking he was seriously cute.  The second time he was my patient he wasn't fairing so well, and I had to transfer him to the ICU because of some bad heart rhythms he started throwing out.

 Later he came to me again, significantly smaller and slower. Apparently the nursing home he had been living at failed to notice that he was having too much trouble with his arthritic hands to effectively feed himself. He was also frustrated that despite his desire to rebuild his strength, no one was ever available to help him walk.  After that, his cardiologist (one of the best in my opinion, to this day) made it a point to visit him there almost every day to make sure he was taken care of.

A few months later, I found myself again his nurse.  This time he was a shell of what he was when we first met.  His skeletal frame was curled painfully in the bed and he cried out every time we touched him or moved him.   He was so weak he couldn't even speak, expect to whisper yes or no.  A few visitors stopped in from time to time, but always left after a few moments of awkward silence in his room.  We find it hard to be with someone when they can't carry on conversation. When it was clear that he was dying, the cardiologist tried to make arrangements for him to be flown across the country to where his son lived, so he could live out the weeks or months remaining to him with his family.

Soon it became apparent that he would never make that journey. He might not make it the rest of the day.  I made the call to his son, who was on the next flight out to see his dad.  The rest of my shift I'd slip into his room and reassure him that his son was on his way and would be there soon.  You could almost physically see him holding on to life by his fingertips those last few hours.

Finally, his son arrived, hurrying desperately to his dad's bedside, eyes full of tears.  "We all kind of think he's been hanging on to see you," I told him before stepping out awkwardly. An hour later, he died.

He was my first patient death, and I'll never forget him.