Monday, December 12, 2005

Impending

It was Thursday afternoon, about one o'clock when I returned to the ICU after lunch. Maybe 1:30, actually. I took a little longer at lunch than I should have, probably.

In the corner room to my left, I saw a nurse motioning for me to come over.

Mr. H was in the bed breathing quickly and deeply. Just that morning, our team had decided that he was ready to leave the ICU and go to the wards, as he was showing improvement after his heart valve replacement surgery. Now he was lying in the same position in bed, but strapped with a mask on his face.

I went to visit with him. Though he was breathing heavily, he was still quite aware of himself and his surroundings.

I went through my motions, examining him, checking his lines, the drainage tube from his chest. Ordered a chest x-ray. Got another physician to look at him and discuss what to do. Developed a plan, executed it.

As things progressed, I continued an interrupted dialogue with Mr. H, noting his awareness and condition. He never really worsened, neurologically speaking. But his breathing problems persisted.

He was quite raspy as well, as previous surgery in his past had left a scarred vocal cord.

"How are you doing," I asked. He nodded his head, and then shook it--probably not necessary to say any words.

"Are you getting tired?" He nodded again. Then he mouthed something. Through the high flow of oxygen through his facemask, it was even harder to hear and understand him.

I leaned in.

"Where's Dr. p? Is Dr. p coming?"

"Yes," I acknowledge, his surgeon would be on his way, though I didn't really know that for sure.

I straightened up and he motioned be back to his face again.

"I don't think I'm gonna make it this time," he said.

"We'll get you taken care of," I shallowly replied.



Mr. H died two days later, his distress and death a result of an infection.

Because he was so short of breath and was soon intubated, I believe those words were some of the last he spoke. So calmly, assuredly.

To me. Or to anyone else.

2 comments:

Blair said...

I'm glad you're blogging more these days. Your daily life contains more fascinating, meaningful stuff than most of us collect in a year.

I don't know anything about that guy, but I'm still sad for him and his family.

On a different note, I'm sure you're secretly hoping for the day when a patient whispers his last words to you, "The combination is..."

Ashley said...

I have been thinking about this story ever since you posted it. I have no worthy comment. All I know is I am glad his last words were to you, someone who would know how significant last words can be and someone who helped him feel assured.

I like that you are blogging more these days!