Life and Death

You get to learn a lots about these subjects when you’re a nurse, but one of the fair things about life is you don’t have to be a nurse to become familiar with either of them. You simply have more exposure as a nurse.

There are two things I’ve learned about life and death in my nursing career. One, when it’s your time to go, nothing will save you. I’ve had patients come up to the nursing station to get their scheduled meds, collapse as they’re going back to their room, and were dead by the time they hit the floor. They had no complaints, no apparent concerns–and then they were DRT. Dead right there.

Conversely, when it’s not your time to go, you will live through everything. I’ve had patients that had shot themselves in the head with a .357. A .22. A .45. I’ve had patients that sliced open their bellies like a samurai committing seppuku. Patients that had deliberately collided a motor vehicle into a bridge abutment, a tree, another vehicle. Patients that had jumped into traffic, off of a building, off of a bridge. I’ve lost count of how many of them tried to overdose or hang themselves. But they had at least one thing in common: they were all walking around talking about it.

Go figure.

My wife has Crohn’s disease. It’s an autoimmune disease where the body essentially attacks itself, resulting in sometimes massive inflammation and ulcerations throughout your entire GI tract. It can result in nausea, vomiting and diarrhea, and pain something like unto that scene in ‘Alien’ where the spooky monsterbeast pops up out of that guy’s chest.

That was what Lea was experiencing when she started the first of her serial admissions to Fairview Medical Center in 1991. Over the next three years she would spend roughly half that time in the hospital connected to so many IV’s she usually needed two IV poles to hold them all, and two or three–sometimes four–IV pumps.

TPN, total parenteral nutrition. That’s two separate components right there. One is a huge bag with yellow fluid that Lea and I called her margarita bag. The other is a small glass bottle filled with creamy white lipids–her Piña Colada. The nurses that took care of Lea liked that and started calling them those names, too. A bag of normal saline with a morphine drip became her martini bag. Shaken, not stirred. No olives. Lea couldn’t eat ANYTHING during these times.

All of her nutritional needs were met by IV’s. She had to have a PICC line for that, plus one or two ancillary lines in her arms. She was on IV antibiotics; we didn’t even try to get cute with that. There were more, many more. If Lea had put a flower in her hair, she could’ve been a float in the Rose Bowl Parade.

And for the record, the real nurses that cared for my wife during that time–you all were rockstars–we loved those nurses, they were all so amazing. They. Were. Un-fucking-real.

Her GI doc, James Kromhout, had no idea what to do anymore because nothing he had tried was working, and Lea only got worse. He sent a consult to a surgeon, Dr John Something… And we waited. And waited. And waited some more.

I ended up writing him a ten page letter, explaining our situation and our frustration. Dr John actually read it. He offered this explanation: Once you open someone up and start taking things out, you can’t put them back in again.

I understood that, but I also knew if he didn’t operate on my wife, and soon, a monsterbeast was going to tear her guts apart. We waited another week. Or two. I started writing Lea’s eulogy. I would get a lots of practice with that literary piece over the next few years…

Her doctors had decided to try high doses of prednisone as a last ditch effort to stem the massive inflammation in her guts. Lea’s condition continued to deteriorate. Dr John finally decided there was no other option and scheduled her surgery.

Prednisone is a ‘dirty’ drug. It’s a very effective anti-inflammatory drug, but it has a lots of nasty side effects. Moon face, weight gain, mood swings, insomnia, mania–even psychosis–plus about a hundred other things.

Lea had all of them, and a bag of chips, on the night before her surgery. I spent that night at the hospital with her. I tucked her into bed, told her a bedtime story, sang her a lullaby–and she closed her eyes. I turned to sit in a recliner in her room, and by the time I got to the chair she was in the bathroom trying to figure out who the person in the mirror was, and how did that person get into her room? I have no idea how she managed to get her IV poles into the bathroom without knocking them over or disconnecting her tubing.

I might have gotten five minutes of sleep that night. My wife had maybe five minutes of sleep that week.

Lea was the first case on Dr John’s schedule that morning. Most abdominal surgeries run about an hour, maybe two at the most. Lea was in the Operating Room for four hours. When Dr John’s scalpel cut through her abdominal muscles and the peritoneum, Lea’s intestines flew out of her body like someone had opened a prank can of worms.

Dr John told me this after her grueling surgery. He removed about half of her large intestine. It was so swollen it looked like the Metrodome. He spent at least two hours stuffing my wife’s guts back into her body, and closing her up before anything could jump out again.

“I think you were right. About the surgery. I should’ve done it sooner.” he said. I think the only thing I could do in response was shake my head.

Whether late or early or whatever, Lea had finally had the surgery I felt she needed to have to save her life. The only question that remained was the Big One about time.

Was it her Time?

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