When the Palliative
Care doctor walked into Vicki's ER room with her kind eyes and rather more
consonants than one usually sees in a last name, my heart sank.
This was it.
She pulled up a
chair and settled in on the other side of Vicki in a position where she could
address us all - Wally, Vicki and I - without looming over us like the other
doctors and nurses had. Her body
language, her demeanor, and her expression all said that this was a
conversation, not simply information passed down to us, or another
examination. We were all involved here.
Shit.
After months of
euphemisms and vague, partial answers from the oncologists, this gentle doctor
was here to talk with us about the end of Vicki's life. And not just in the abstract, but here. NOW.
Vicki had been
vomiting blood. Her skin was pale and
pasty, her blood pressure as low as it could possibly be while she was still
alive. She was talking and seemed
cognizant about where she was and what was going on, but when the doctor
started asking questions it was obvious that she was confused.
"So,"
Doctor Z-B started gently, addressing Vicki directly and nodding her head to
encourage a response, "what do you understand about your cancer diagnosis
and the treatment you've been having?"
Vicki answered
slowly but with seeming clarity that she was doing chemotherapy and that her
goal was a cure of her cancer.
There was a bloom of
silence in the room as Wally and I absorbed Vicki's lack of comprehension and
the doctor reassessed how much information she needed to give us. Wally and I both shook our heads lightly,
trying to convey to the doctor that we understood what was going on, even if
Vicki didn't.
Cancer was coming
for Vicki like a freight train - incurably, inevitably. We'd been watching the headlight in the
distance for months, but now the train was getting closer, the sound of it roaring in our
ears.
The doctor started
her compassionate explanation of Vicki's current state of health and I marveled
at her skill with words. She was clear
but not shocking, kind without platitudes, and carefully, empathetically honest
about the fact that Vicki was - right this very second - teetering on the
precipice of dying.
While she was
talking, I looked at the doctor's lapel and rolled her nearly unpronounceable
name around in my mind. I wondered about
her very thick glasses - when I was young, they were called "Coke bottle
bottoms" - and imagined her as a small child, getting her first pair
and being excited to finally be able to read clearly. I pictured her capable-looking hands playing the
piano for many years, and wondered if music was a source of comfort for her or
just another acquired skill. I wondered
if she had been teased for being sensitive, for being small, for being much
smarter than the other kids, for having enough ambition to become a
doctor. I wondered if her hyphenated
last name came from her parents, or from her own marriage. I wondered how old she was, how long she'd
been doing this job, how many families she'd delivered undeliverable news
to. She seemed to know exactly what to
say, what questions to ask, and how to clearly, precisely define the edges
between routine care and heroic life-saving.
Vicki had a Do Not
Resuscitate order on file and was currently in the perilous state of possibly
needing resuscitation. Soon.
It was Dr. Z-B's
job to help us clarify - for ourselves and for the hospital - exactly what situations
that DNR order applied to. She gave us
several possible scenarios and asked Vicki directly, "What would you want?"
Vicki looked at me,
unable to formulate an answer, and so the doctor asked me, "What do you think your
sister would want?"
I opened my mouth to
answer, but started crying instead.
My sister would want
to hold her grandbabies.
My sister would want
none of this pain, these treatments and the ridiculous regimen of dozens of
medications.
My sister would want
to laugh with friends, to take selfies with her husband on the beach, to catch
up on Facebook while sitting on the toilet, to hop on a plane and go someplace
warm, to eat at a nice restaurant, to watch her kids finish growing up and to
take naps on Saturday afternoons.
But barring that,
finding herself in this awful cancerous predicament, my sister would want me to
get the pillow and put her out of her misery.
Vicki and I had had
a "pillow pact" for many years.
After watching helplessly as our elderly grandmother lingered for weeks in the
hospital without eating, talking or knowing what was going on around her, we
both declared that we would much rather die quickly, and vowed to smother the
other one lovingly and without regret should the occasion arise.
And now the occasion
was here.
Vicki was standing
on the train tracks with the engine barreling straight for her, and what was I
doing? Standing mutely off to the side,
watching it happen. Unable to speak, unable
to help, inept and useless.
I turned my head,
not wanting Wally or the doctor or - most importantly - Vicki to see my tears.
I stared at the
machine recording Vicki's erratic, elevated heart rate, her O-sats and blood
pressure. I thought about her heart,
beating on like a soldier, even as the rest of her body was failing. I thought about what she would do if our
situations were reversed.
Vicki would be so
much better at this. She would know what
to say, what to do.
"It's just…
sad," I finally answered, which wasn't an answer at all. It was lame, obvious, unhelpful.
I wiped my eyes and
held Vicki's hand, bracing for the impact of the coming train.
There was nothing
else I could do.
