Unconsciously I tap my toes to the rhythmic whirr-click of ‘Gertie,’ the oxygen condenser that sits between my sleeping area and the hospital bed that holds the waning essence of the friend I’ve known throughout the ages. Silent, numb, and so very lonely, I listen to Jill the Hospice nurse as she goes through her paces of assessment, examination, and compassion. “Bill, can you say hi? It’s okay if it’s too hard to talk, just squeeze my hand to say hi to me and Kathy.” Bill’s delicate skeletal hand remains limp and unresponsive. She looks up and slightly shakes her head.
I set aside the vials of medications that I’d been using as a distraction and decide not to share their misrepresentation. The morphine should read ‘a promise left unkept.’ Those labeled Haldol and lorazepam held ‘choices he’d never make.’
It only takes two steps for me to be by his side. “He hasn’t responded to me at all today.” I lightly brush my fingers across the paper-thin skin above his brow. “I can’t tell if he’s still here.” For the briefest of moments, I allow myself to feel the fullness of the love and gratitude for the man I’ve had the privilege of having as one of my best friends.
A single choked sob escapes me; I gasp and swallow the ones that race to follow. Not yet, or your crying will never stop. Jill looks toward me with empathetic compassion, and I see she’s trying to find some words of comfort. I can’t handle it right now. I gesture toward the table. “On that clipboard are the medication records I’ve been keeping, along with some checklists and schedules I put together when I couldn’t sleep.”
She picks up the clipboard, her train of thought successfully interrupted, and chuckles while thumbing through the tabbed pages, “You know Hospice doesn’t require any of this, you’re working way too hard. But I understand where you’re coming from, I’d likely do the same. ‘Once a nurse, always a nurse,’ as that old saying goes.”
“They help me to keep everything straight in my muddled-up MS brain, I get so tired it’s hard to remember when I’ve given him his meds or to keep track of everything that needs to be completed.”
“Wasn’t his sister flying in from Indiana? With your Multiple Sclerosis you need more help than what our team can provide.”
I slump further into the chair. “It’s what I keep saying, there isn’t anyone else.” My focus strays toward the vials, a promise still unkept. “Debbie’s having issues with her boss and isn’t sure she’ll make it because she could lose her job. Our friend Gary comes by with food and helps with laundry or the dishes, things like that. But he gets weepy and anxious if Bill gets restless or has difficulty breathing.”
She turns to a page in the folder labeled with Bill’s name. “Tomorrow we’ll start spreading out our time, giving you the chance to get some rest. I’ll go make some calls.”
“Thanks, that should help.” My response feels dispassionate and rehearsed. What about tonight?
A dark hollowness swirls around me in the heaviness of my fatigue, in flashes I clearly hear Bill’s voice, ‘Let me go if there’s no hope, for my sake as well as yours. I can’t bear the thought of lingering on a machine or of being all doped up. I’ve been clean and sober for over thirty years, and I want to stay that way until the end. But if there comes a time when you no longer feel my presence, promise me you’ll find a way to help me fall asleep and pass from this life into the next.’ Such an easy promise to make since I wanted the same for me. But now….
With a jolt, exhausted reality returns.
“Sorry, didn’t mean to make you jump,” Jill laughs. “How’s he doing with the medications? Any seizures? What about the restlessness and delusions?” She picks up a vial and continues, “What about the morphine, does it still help to ease his breathing?”
“The meds must be doing their job. No seizures, no wandering around or falling, and the morphine along with that machine ensures his breathing won’t soon stop.” Yep, everything’s just friggin dandy. I grab the handle of my walker, “I’m sorry, I’ve got to get out of here.”
With my left foot dragging behind me, I shuffle toward the back patio. I need at least one minute to be myself, not a friend, not a nurse. The cool blast of late February’s moist air is oddly comforting, and I ease myself into a hard white plastic chair. Finally, the tingling numbness of my left cheek and the pins and needles traveling up and down my legs slowly begin to fade.
My inner dialogue of guilt and sorrow is incessant and I’m unable to stop the flow of thoughts or words. Bill’s quick decline is not your fault. The narcotics that cloud his mind are therapeutic, he needs them to prevent the seizures that come with the infiltration of the cancerous tumors that are invading the recesses of his brain. Remember the falls, of having to call the medics when you couldn’t help him off the floor. Get it together Kathy, you’re doing the best job that you can. But this is not a job… he’s not a patient…he’s my best friend. But is he still here? Where is the essence of Bill’s heart and mind and soul? I only see an empty hull. What about your promise…?
The cool air that at first was welcomed now chills me to the bone, and there’s a shadow of a tingle in my left cheek, a sign my MS stress symptoms are returning. I bury my angst and fear, guilt and sorrow and resign myself to what awaits inside.
Before saying goodbye to Jill, I step into the small half-bath to finish gathering my composure and catch sight of my reflection. My clothes are hanging loosely, my hair lays flat against my skull and dark circles beneath my eyes envelop half my face. When did I last shower? Or sleep more than two hours at a time? Or even eat?
Moments later I’m alone again with only the mechanical whirr-click of Gerty, and Bill’s raspy breaths to fill the silence. I turn on the TV and begin the evening’s routine of comfort care and medications. While moistening his dry, chapped lips I see a face which no longer reflects the man I’ve laughed and cried with these past twenty years. A cool shudder races through me with a lightness that’s both numbing and full of pain. It’s time...
With vacuous detachment I watch myself tearfully fill two syringes with enough of the clear blue liquid morphine so Bill can sleep eternal and listen to my soliloquy. Words, spoken both out loud and silently within, are filled with laughter, gratitude, and tears. I re-live our Hawaiian trips with Gary, as well as the adventures we encountered when driving halfway across the country. And convey my gratefulness for helping me learn to cope with the challenges of MS. But most of all I thank him for the gift of my sobriety, both as a friend and sponsor. The full impact of what our friendship has meant to me cause my words to fade. For a time I sit next to him in silence with my hand resting above his slowly beating heart. The promise is yet unkept.
Time has stopped, it has no meaning. It’s just him and me and the two syringes. A chill radiates from my core, my gut twists and cramps. My hands grow clammy, numb, and tremulous. I lean over, tenderly kiss his forehead, then whisper, “I’m so sorry Bill, I can’t.” I set the syringes down.
A nebulous mist of unspent tears, guilt and questions become a shroud as I go through the motions of caring for my dear friend that evening and into the next morning. What stopped me? Could it have been the specter of my emotional and physical depletion, so evident in my reflection, that filled those two syringes; not the friend who was honoring her best friend’s wishes with the love and respect that he deserved? Is that why the promise went unkept, or was it something else?
An early morning call brings a slight relief to the onus of my guilt. “Debbie’s on her way my friend. If you can, try to hang on for a little while longer.” Did he know that she was coming? Did his unseen hand release me from our pact? He gave no indication.
Mere hours after her arrival, with both of us near his side, Bill’s sojourn upon this world drifts gently to an end.
“Kathy, I think Bill’s ready now,” Debbie’s voice cracks and quivers after we finish dressing him in his favorite t-shirt and blue knit hat, “and if it’s okay with you I need to step outside to get some air.”
Before sitting down, I softly stroke his still warm clean-shaven cheek, “Go ahead and take your time, it will be nice to sit and relax with him again.”
Debbie smiles weakly, her eyes moist with welled up tears. She gathers up her coat and phone and rushes out the door.
Alone, an unexpected restlessness compels me to shuffle about the room. I grow irritated when my MS tingling, dizziness and numbness cause me to almost trip and fall. For god’s sake just relax, this is the first time in months you have no urgent tasks. Something doesn’t feel quite right. My unease grows, I look around. Bill should be resting in his home and sanctuary, not this portal to demise. I shove all evidence of the scourge that robbed me of my friend unceremoniously into a corner. The meds, the paperwork, bedpans and all the rest; then finally the now-silent Gerty is covered, is hidden from my sight.
Now once again I see and feel him while we’re alone together in the treasured silence of his home. The pure essence, heart and soul of my best friend, lying peacefully in repose.
Author: Kathy McKnight
Comments