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23 June 2009

Passing Gentle Into That Good Night

Yesterday (Monday), we had the autopsy of the first case of H1N1 Flu to die in our area. It was very sad because the young man was so young and previously healthy. I wasn't present at the post-mortem because of the high level of precautions being taken. However, I did hear about the case during morning report, and one of my colleagues is on their PICU (Pediatric ICU) rotation, and I heard some information from them.

Today we had three cases. Three people who died in their sleep and were found after a friend, relative, or neighbor grew concerned enough about them that they sent someone to check on their welfare. In one way, I think most people would like to just pass from this life in their sleep. A simple blink from existence. However, I found myself somewhat saddened by their stories, because to me they died alone. Although someone checked on them, thought enough about them to be concerned, no one was actually with them when they passed.

I think I've only been at the bedside of one or two patients when they've died. Both of which I later had to deal with guilty feelings for turning off the ventilator. Medically, I knew that they were brain dead. I knew that the best thing I could do for them was to let them go. Emotionally, though, I still felt as though I was the one ultimately responsible for their death. I talked to their families and got them to understand that their loved one wasn't going to recover. I signed the orders for morphine and to stop medications to keep their hearts going and their blood pressure up. I turned off the breathing machine. I pronounced them when they flatlined.

I thought a lot about Dylan Thomas' poem today. As a physician, and especially one who works the "front line" in the E.D. , I can't help but daily think I "rage, rage against the dying of the light." And, when we lose the fight, I am glad that someone was there to witness and to pray.

Do Not Go Gentle Into That Good Night
by Dylan Thomas

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.

Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.

Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.

Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night.

Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.

And you, my father, there on the sad height,
Curse, bless me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light.


a corgi said...

(((Veronica))) I remember years ago when I still worked in doctors' offices I worked for a cardiologist. I paged him for something or another and when he answered he said he would be up to the office after he waited for someone to pass on. I guess he was sitting with them until they did. (our office was based in a hospital setting). I never forgot that, that he would take the time to spend with the patient for whatever reason.

I know some nursing homes have volunteers that come and sit with patients that they feel are on their literal death bed so they won't pass alone; I understand volunteers pray for them, read to them, hold their hand. What a noble thing to do.

My sister, 3000 miles away, sat with my mom when she passed. She wisely had decided on palliative care (85 years old with fungal pneumonia and not responding to treatment, slipped into comatose state). I was glad she was there for my mom.

I also was glad I knew where my mom was going after she passed so when I said goodbye to her in her comatose state, I hoped she heard me but I told her to go home and dance with Jesus. I did pray she would have a death that was peaceful and I truly believe the Lord answered that prayer. I'm praying that prayer for my hubby's parents that they basically fall asleep here on earth and wake up in heaven. Wouldn't that be glorious?


Julie said...

In 30 years and 10 years of that spent on Oncology I have been with maybe a hundred or more people when they die. Many times if the family isn't there, or there isn't family a nurse or aide will sit with them when the time comes. But, for many people at the end they turn in and away from people their last days. It's a journey they take alone but not really because I can't tell you how many I have seen reach out for the one on the other side helping them over. And I truly believe it.

Jeanie said...

I'm with Julie when she says the 'dying patient' reaches out for a loved one. That happened to my dear MIL. She sat bolt upright in her hospital bed, when previously she was slipping weakly away. She stared wide eyed at someone, past my husband who was standing at the foot of the bed. I know she was passing on to meet up with Chris her husband in that moment.
God bless the young man who died from that terrible flu Veronica and the three others who died alone indoors.
We had a wonderful neighbour in the late 1950's who came and looked after all of our family who had come down with the Asian flu at the same time. She was a saint.
NOt many folks would do that for strangers as we had only just moved there.
Stay safe from this disease Veronica. You are in the frontline of it all.
Saying a wee prayer for you.
Jeanie xxx