06 July 2011

Yesterday, I wrote about what I remembered about last year and David's death. I was sitting by our Bay at the times indicated. There is one more part of that morning that I want to remember. Later.


11:29 -- It was just about now, a year ago, that the heroic effort to re-start David’s heart began. Whenever I think of this moment, I am flooded with images and feelings, and also an after-fact that I learned from my sister. That once they bring in the paddles and injections, and army of personnel, the battle is almost assuredly over. Very few people whose hearts stop and do not almost immediately re-start are revived. I did not know that. When I think of it, it makes me both sad for the wasted energy and effort and cost of all the expensive means being used, and also grateful to those who rally and try. Try incredibly hard. How many times a day, a week, during a career, but very little success. And still they work at it.

I’m sitting on a bench by our little bay, two short blocks from my house. How fortunate to live near water. How spectacularly wonderful right now. I can sit on a city bench -- that old kind with concrete side and old planks of wood making the seat. David and I and Julia and a few times friends sat here. Evening walks. With the dog. We inhabited this space. And it is nice to be where we inhabited together. It feels right to be outdoors.

11:43 -- they had been working on David’s body for more than 10 minutes now. At first, I stayed in the room. Then the room filled with more and more people and machines. More vials of drugs pushed into syringes sat on the bed stand. I stepped out -- did someone ask me to? At first, a nurse or nurses, assured me. “Don’t worry” or some such thing. I didn’t. Scared. Very much so, but not ultimately worried. We had gotten through so much up to that point. This was another bump, another challenge to rise to and recover from.

11:46 -- They finished by this time. They asked me to come into the room and to tell them to stop the artificial means of keeping David’s body alive. For a moment I wondered whether I should tell them to keep going until Cheshire got there. She was on her way. But why? He was not alive. There were no words to say, even looks to exchange. Just a body, his to be sure, but a body that was being kept alive by others massaging his heart and pumping air into his lungs. And so, I said stop. And then, I let go. Then, I cried. I wailed. I did not know I was capable of such emotion in front of strangers, but these were the people who had tired so hard to make him live again. Were any of them strangers? I heard someone “call” the death for 11:45. My reference was tv doctor shows but there was no question what was said and what it meant. I don’t know if that is what the death certificate says.

I have never been one to cry much. I seem to have saved up years of tears for this death, for the remembrance. Sometimes I wonder if I will ever stop.

Cheshire came. It was very soon after the “call.” I think the room was rather empty by that time. She saw me from the door and she knew. I don’t know if anyone stopped her before she came to the room. We stood and either side of the bed and cried. We held hands some. I must have explained something. We cried.

Someone asked -- a nurse set to watch over us -- who she could call. My first impulse was no one. No one needed to knew this sadness, this complete loss. But she insisted and I handed her my phone and asked her to call Lisa. How awful it must be to make such calls. How hard is it to be a stranger who is calling probably the closest person to the grieving about the death. I have no idea what was said. She may have stepped out of the room. And then, she was telling me that Lisa would come. But who else, she wanted to know. And I asked for Mary. Mary, just a town away, not hundred of miles. And Mary was there before we left David’s hospital room, hugging us and soothing. I do not even know what I interrupted. I don’t know what she put down to be with us. And she stayed the day, the evening, and was back the next day. Lisa was with us by nightfall. And Linde, Cheshire’s dear friend, by the next.

After a long time, and no where near long enough -- I probably stopped crying for the moment, stopped touching David’s body, the nurse (and I guess she could have been a social worker. The nurse who stood by me in the hall after a time when, I am sure the end was guessed, might have been replaced by a social worker. I have no idea who that person was, what she looked like. And I feel badly that there is no way to look back and say thank you.) asked us to move into another room, a quiet office type room where bad news is delivered and families grieve. Just down the hall. And we would be allowed to see the body again. They would clean up the room. David’s room. Put the room and the body in order. Assurance. I did not want to leave. They let me stay. Who is the they I write? Maybe the nurse, maybe Mary, maybe Cheshire? I remember more than one voice urging me to leave, but assuring me that I could stay as long as I needed. The lessons of death, the needs of the grieving, the shocked, those who wander in a limbo land are probably well known by all on that floor. That acute care heart floor. David’s room was a step down from the heart ICU, but steps away.

When they were working on his stopped heart. At first, a nurse assured me that as soon as they got it started again, they would be transferring him back into the ICU. “We need to stabilize him first.” Or something like that. Much later, that day or another day, when I spoke with one of the doctors, he or she said made reference how they had managed to start the heart a few times before. And the knowledge, the full awareness, that David had never been out of the woods, and that for all of the progress he had made, his condition was much more fragile that he/I/we had understood, flooded in. His heart had stopped two nights after the transplant, when he tried to get out of bed and fell. I knew that. I cannot remember the words now, but that phone call in the middle of the night, included technical words that meant, he died but we managed to bring him back. I had conveniently, in the intervening time, filed that information very deep inside.

And the night of the rush to the ER the week before his death, they had “lost” him for a few moments during or after the move to the ICU. Again, words of science were used and I allowed myself to let the information go deep.

So, when the nurse told me of the transfer back to the ICU as soon as they could get David’s heart started, I was more comforted than I should have been. This was going to be like the other times. I thought that David was going to be very disappointed at the regression back to the ICU, but we would become more patient, work at our patience to recover.

I paced outside his room. Craning my neck to see what was going on. I remember the paddles, the shocks, and no heart beat but no easing of the effort. Was it five minutes in or 10 that someone asked if I should call someone? It was forever and it was not soon enough. I called Cheshire. What did I say? To come right away. That something was happening. To ask Maria to come over. To call Cathy. And then, I worried about her. Doing what she had to do to leave Julia and driving to the hospital knowing that her father was dying or dead. Did she know that?

It could have been hours, standing there outside the room. The room that was busy with people shouting orders, trying what they could, pumping, clearing, shocking, looking at monitors. Hoping. Hoping. Hoping. The nurse put her arm around me. I was still so strong and sure that it was going to work. That I would see his eyes flutter open and a wan smile cross his lips. And I heard a woman say, “Is there anything else anyone can think of to do?” And murmuring. My mind raced; I did not breathe; I was numb; I was sure there was one more idea; I knew. I knew. I knew.

And then they called me in. And I stood at the foot of the bed. For an instant, I thought to move to the head, with them, the professionals. But I knew, when I stood for the merest of moments that it was too late to stand anywhere close. I was where I needed to be.

Stop. Yes, they could stop.

In the room that the nurse ushered us into -- Cheshire, Mary, and I -- I knew that I needed to make phone calls. There was a moment when I did not want to tell anyone. Again, I was aware that this awful thing that had happened might be contained between the three of us in this little room. No one else need know, need be sad. No one else need be concerned. For moments I wanted to spare the world. Our world. I wanted everyone else in the world to believe that David was still alive. And by some magic he would be for them for a little more time. At the same time, I was aware that there was a hospital full of people who knew -- at least those who cared for David -- there was my neighbor who knew that something critical was happening and my friend Cathy, who would replace Marie to take care of Julia. Lisa knew. Mary knew. I could not contain the news, the knowledge. My image was that of trying in vain to collect spilled milk.

At some point, the phone rang, and Mary took it from me and answered. I think it was Lisa to tell me she would be there that evening. Is that true? How did she arrange it so quickly? I called David’s father first. It was as soon as I could, as soon as I was in enough control to manage talking. It was the most horrible call that I have ever made in my life. The most awful of conversations. What are the words to tell a 92 year old man that his son was dead? Dad almost immediately started blaming the doctors, the choice of the heart transplant, our trust in our doctors. Looking at it now, I see a reaction to David’s mother’s death 30 years before. I believe that she suffered the same pretty rare heart condition from which David did, and although there was absolutely no way for her doctors to find or correct the condition, those doctors had made mistakes. Their mistakes may have been justified, may have been likely diagnoses, but they were wrong. I don’t remember his anger about that. I did not see it. I do not assume that it was completely unexpressed, but I do not know and probably will never ask. Maybe some of our situation was the same, maybe mistakes were made, but the mistakes, if there were some, were studied guesses and best efforts. I cannot fault those who made them.

But David’s father was angry, almost angry at me, certainly almost scolding, and wanting very much to blame. This was hard for me. Harder than I knew at the time.

I called my sister. I called home to tell Cathy who was with Julia. I called Marilyn, our attachment therapist, who was on vacation on the west coast. It was rather awful to call, but I needed her help and I could not stop myself. What should I say to Julia? What should I not say? I caught her off guard -- as if she was supposed to know -- and I could hear in her voice that she had been on vacation far from the worries of the children she heals. But she talked. She gave me herself and was willing to let me take her time as I needed it. I was the one who cut the call short when I realized that I knew what I needed to do and how to do it. I realized that my instincts were fine. I remember asking for or wanting from Marilyn magic words. I remember the absurdity of the idea.

And after a time, someone came in the room and explained that they had cleaned up David’s room and that we could go back in if we wanted and stay as long as we wanted before the body would be brought “downstairs.” Did that say that? Or do I just remember it as that? Mary and I went in and Cheshire stayed behind. She was finished with the body. I cried some more. I touched his hand, his face. I kissed his cold face. He was so much there. So much himself. And so dead. So far away. So not there at all.

Our stuff -- what he had at the hospital, my bag, and computer were in a neat pile to be picked up before we left. Which we did. Mary did it. It was when I saw the back of his neck begin to turn blue from a pooling of blood that I could move on. Move on. I hardly did. I moved as I was directed, only with some of my own efforts.


Traci said...

I'm here. I just wanted you to know. I pray that I have a chance to hug you soon.

Love, Traci

chayadina said...

We are a few weeks late but we have been thinking of you and remembering David. Wishing you continued safe and contempletive travels on the East Coast. We enjoyed seeing all of you at Matthew's graduation. Let us know when you will be returning to Madison in case our next visit coincides with your schedule.