Despite Knowing the Journey and Where it Leads…

“Despite knowing the journey and where it leads…I embrace it. And I welcome every moment of it.”

– Louise Banks’s monologue, Arrival

*Trigger warning: Personal accounts of stillbirth/child loss and grief are mentioned in this post.*

My sweet Ezra,

Today is your first birthday. A part of me marvels at the idea that it’s already been one whole year. Then, another part of me thinks, “How can it have only been one year?!” Time stopped for me, but I remain an observer to the ever rapidly-moving world around me. I remember sitting with you, singing and talking to you that final Sunday in May. In the mirror, I could see myself growing, and was only made excited by the prospect of becoming more planetary by the moment. I can even remember telling you about the pastel lights, in a long row of lanterns in front of a neighborhood just down the street from ours, turning on as I drove home from work that same day. Honestly, it stings to think of the moments before your death…to consider how normal and blissful everything was before my whole world was turned upside-down.

Every day since you died, you have been at the forefront of my brain. Doing anything is a struggle, and requires what feels like a herculean amount of focus and intent. I find myself constantly bargaining. While I know time won’t magically turn back the moment the clock strikes 6:42AM on June 1st, I keep hoping it will. Hoping that this year was a nightmarish test of some kind, and that one day I’ll wake up to find you sleeping soundly in a bassinet by my bed after I’ve learned the appropriate lesson.

I have this image in my head of you at about two years of age, coming up behind me and wrapping yourself around my neck in a tight hug. At work, I stare longingly at brand new 33-weekers sleeping soundly in their isolettes. More and more, I wonder who you would be today. It’s a miserable exercise, honestly, pondering the things that will never be. But all of the love I have for you has to go somewhere, so I find myself daydreaming about the incredible person you’d be if you were still here with us.

For as sad as I am on this day, I want you to know that I love you. And, despite the pain of this year…even if I had known what was going to happen, I would not trade the 33 weeks and four days of your life for anything else. You are my mine, and I am yours. Forever.

Happy birthday, my sweet, precious boy…

Ezra Wilde Kovach, 1 June 2020

4 East

The last child I held

was dead for at least twelve hours.

Sometimes life has a way of coming to the end

before it’s even started.

The hall was quiet with the deafness of

mourning, but there was a peace in your room

I never want to understand.

And your sweet husband was holding your boy

on his skin like a prayer

and I thought

Oh, to be loved like that.

I did my best to memorize him,

take in the slight fingers and the

soft brown hair,

but I didn’t see the color of his eyes

or the tiny little hairs on his tiny little legs.

I never got a chance to hear him say mama

or watch as he

lifted his head for her voice,

but I did hold his body at the same

precise moment as

God.

I still hate when people say things like

He would’ve started kindergarten this fall

but he would’ve turned one this winter

and two the next, which feels like

a mounting hurdle as opposed to

the healing of time.

And this whole thing is preposterous

because he’s not my son

and there’s no way I could understand.

I guess I just wanted to tell you

I miss his slight fingers and

soft brown hair

and I also mourn

for the things we will never know.

-Megan Ulrich, Return Unto Me

Nobody Prepared Me for Life After Your Death

*Trigger warning: Personal accounts of stillbirth/child loss are mentioned in this post.*

The day you left, I wasn’t prepared. Then again, who could possibly anticipate how to feel or respond when told that their child’s heartbeat has inexplicably stopped? I was alone that day — driving myself to the hospital in the wee hours of the morning because I was sure I must be overreacting. There was no way that something serious could be wrong. I’d inevitably be discharged and home again later that morning…right?

No. Not in the least.

The doctor simply looked at me with tears in his eyes, almost whispering, “I am so sorry.” I don’t think I ever heard either of us use the words “no heartbeat”, “dead”, “lost”, or “gone” in that moment, because they were superfluous. I knew what he meant. It was 2:15 in the morning. When I called your papa to ask him to come to the hospital, I simply asked if he could find someone else to look after your sister. He was positive he knew what had happened as I sobbed between sentences. I should’ve been more straightforward, though; told him exactly what happened instead of leaving him to wonder, perhaps with a false sense of hope. But I couldn’t bring myself to say it out loud. That would mean that it was real.

My first thoughts were those of utter disbelief. I did everything I could to take care of myself for your sake. Especially during a pandemic. Not only am I your mother, but I am a nurse. I had been working just down the hall five hours earlier. How could any of this possibly be real? What did I miss? What did I do to have lost you like this? Then, I imagined my name appearing on the L&D grease board — the reason for my admission no longer reading “decreased fetal movement”, and so cruelly screaming “fetal demise”. I believe my coworkers must have known the true nature of what had happened before your own father did. I waited for him as I clutched my abdomen, rocked back and forth, and said “I’m sorry” over and over again.

When he arrived at the hospital, we held hands, cried, and asked, “What now?” We would utter those words through the rest of the day as we were guided step-by-step through every decision we had to make. Your papa looked at me solemnly and said, “At least the worst part is over.” Because he believed that learning you were gone would be the most painful part of this whole process. I began to sob again, and told him that the worst part wasn’t over…because now we had to deliver you.

I remember the cold, bright operating room and sitting upright as I moved onto the operating table from the gurney. My hard chart was in the corner, and it had a giant, purple butterfly taped to it. I was still hoping that this was all some horrible nightmare. Somehow, that butterfly was confirmation that my life had become the living embodiment of every worst-case scenario I had ever imagined.

I wasn’t prepared.

Nobody could have possibly prepared me for the silence as you were born, with the exception of my crying. I did not expect an acute feeling of emptiness to take hold as the doctor gently guided you out of my body, nor the wave of grief as a nurse said, through her tears, “He’s so beautiful.” The peace I so suddenly felt when I saw your face and felt your warm cheek against mine caught me off-guard. I could’ve been so easily fooled into thinking that you were still alive.

I wasn’t prepared.

I wasn’t ready for any of this.

But how could I have been?

How could anyone have been?

I wasn’t prepared.

When I was wheeled out of the hospital with a weighted teddy bear, the blanket in which you were swaddled, and a memory box in my lap, I didn’t realize it would hurt so much to leave you behind. To drive away, and never see your sweet face again. To see you nine days later in a tiny, sealed box carried by your papa from the hearse to the place where we would bury you.

Nobody ever told me I would ache with every thought of you, and that every aspect of daily life would become a constant reminder of your absence. Never could I envision a time when your big sister would ask to visit her baby brother, because you would never come home with us. It never occurred to me that my home would become my only refuge; that I would be reluctant to leave it for any reason at all.

I wasn’t prepared to lose my sense of self.

I didn’t know that a part of me would die with you.

I wasn’t ready to let go of the dreams and hopes I had for you, but they were already slipping away.

Dear God, I wasn’t prepared!

Before this, we owned one vase that frequently disappeared whenever we needed it. Now, flower arrangements were dispersed around the house. I would cry as I thinned them out when the flowers lost their color and shriveled. A large collection of vases would gather in a small corner as the flowers died. To this day, I almost cannot stand to have bouquets of flowers inside of the house.

Who could have told me that I would stare out of the window to the backyard for hours, hoping that the yellow butterflies and humming birds were a sign that you are okay? Wherever you are…

Who could have anticipated that I would want to talk about you every chance I got? I sought advice from support groups, feeling some semblance of peace for only a short time. I eagerly, and almost impatiently, looked forward to the next opportunity I had to talk with other bereaved mothers. It was the only way to keep myself from drowning in this deep, ubiquitous sorrow that stole all of the color from my world.

Not one person — not even another bereaved parent going through the exact same experience — could ever have prepared me for the dark, sinking, relentless pain that has devastated every aspect of my life. I can feel it in my bones.

As the days pass, the dark moments don’t feel all-consuming. They haven’t gone away completely, and, according to every article I have read and every bereaved parent I’ve ever met, they never will. Fewer days are entirely eclipsed by the overbearing cloud of grief. Nevertheless, despite however illogical and counterintuitive it may sound, I almost don’t want the pain to go away. I have photographs, your blanket, the hat you wore, your baby band from the hospital, etc. But none of that is you. The pain almost feels like the only thing I have left.

Recently, we watched Westworld. In it is a character who lost his son. He talks to his wife about his grief, and her words changed, in part, the way I thought about my life without your physical presence.

Bernard: I think about him every day…I turn expecting to see him. But he’s not there. He’s never there.

Laura: When he died, I remember thinking it was like the sun had gone down and it was never going to rise again. I walked in the dark for so long. I don’t know why people said [“if you love someone, let them go”]. If you love someone, why would you ever let them go? That’s what saved me. The only part of [him] I had left was his memory. And if I died, the darkness would take that, too. But if I kept moving, I could find the light again. And I could bring him with me.

I don’t know what the path ahead of me looks like, or if I will ever fully succeed in finding the light again. Everything still feels so hopelessly dark, but I will try to keep moving forward for you, and everyone else I love. I will do my utmost to honor you and try to make you proud. I’ll bring you with me. Even if I never feel adequately prepared to face what lies ahead.

How to Save a Life

*Trigger warning: Personal accounts of stillbirth/child loss are mentioned in this post.*

At one point in my life, the world seemed to have something vaguely resembling order. With the passing of time, though, my rose-colored lenses have turned quite grey with every painful reminder that there are so many things over which we have very little control. In my case, it was the very unexpected loss of my son. It is heart-wrenching, and I am told I did everything I could for him in an impossible position. This does not, however, completely discourage my desire to decrease the odds of a tragedy like mine entering someone else’s world.

Almost three months ago, my son was stillborn. At 33 weeks and 5 days gestation, I went to the hospital concerned about decreased fetal movement. I just so happen to be an expert worrier, so I thought it was likely all in my head. Instead, while sitting by myself in a darkened exam room, I was told that my son’s heartbeat was gone. Since losing my son, I have heard stories like mine told time and time again. While completely horrible, I am not alone in this experience, and all of us are left wondering what happened.

Once a baby is born and ready to go home, nurses give discharge instructions for infant care, including how to prevent sudden infant death syndrome (SIDS). They teach parents how to properly install a car seat, and how to appropriately buckle their newborn into it to prevent injury should they be involved in a car accident. People know that children can die. Why, then, isn’t safeguarding against stillbirth more strongly emphasized in a pregnant woman’s prenatal education?

When most women find out that they’re expecting, they begin to plan. They imagine a life full of giggles and morning snuggles. One thing they also imagine is how their child will enter this world. In an ideal situation, every woman would experience an uncomplicated vaginal birth. In a perfect world, nobody would have to worry about hearing, “I’m so sorry…there is no heartbeat.” We wouldn’t have to make elaborate plans to prevent severe infant head trauma or cord compression during birth. Sadly, these things still happen, and I wonder how many mothers are aware that their giddy anticipation on or before delivery day can so easily disappear.

For centuries women have been giving birth without the assistance of medical devices like a fetal Doppler. But, as a NICU nurse, I have seen more than my share of neonatal injury and death as a result of hypoxia — following the birth of an unmonitored infant whose cord was unknowingly compressed. So many women make the decision to labor freely, without the constraints of fetal monitors, but, as a mother whose baby’s heart just…stopped without any plausible explanation, I have become a strong advocate for choosing to monitor a baby during delivery.

Birth plans vary widely depending on women’s personal experiences, birth stories told by friends and family members, family medical history, etc. There is no one-size-fits-all birth plan, but there are some recommendations:

1. The first is an intervention easily employed prior to an infant’s birth: kick counts/monitoring of a baby’s typical intrauterine activity (and immediately seeking help when there is any behavior outside of a baby’s norm).

2. Have a trained medical professional guiding each birth.

3. Whenever possible, monitor the baby’s heart rate during delivery.

Last week, I ordered some pamphlets from an organization that exists explicitly because its founder and staff have personally experienced loss. They are making a valiant effort to improve pregnancy outcomes. It was something I stumbled upon in my frantic attempt to understand why my son died, and to know if there was anything more that I could have done. When the pamphlets arrived in the mail yesterday, I sat on the couch reading through one entitled “Parenting in Pregnancy”. I started to think out loud while my daughter watched a children’s show and my husband read in a chair across the room.

The pamphlet said that babies don’t usually sleep for longer than 90 minutes in-utero. I had started to feel anxious that something was wrong at 9:00PM the night before we found out that our son was gone. I didn’t make it into the hospital until about 1:00AM. I started talking about how important it is for women to know this information. I almost began to rage about how pregnant mothers should be more strongly encouraged to advocate for their babies when they feel like something might be wrong. Because I dismissed my concerns as a product of my anxious brain. Because I doubted myself at a crucial time, and in a situation where an earlier intervention might have made all the difference.

My husband asked me to stop talking about it. I continued to think out loud, and he sternly told me that my son’s death was not my fault, and that I needed to stop what he perceives as destructive thinking. And, perhaps he’s right. I have heard so many times that any information for pregnant women directly addressing stillbirth can only cause undue stress. But I have always felt that knowledge is power. I will do whatever is necessary to spare someone else the visceral pain of holding their lifeless baby in their arms. I want to save others from the anguish of driving home from the hospital with a memory box in their lap and an empty car seat, walking into a quiet nursery, and burying a baby in a hopelessly tiny coffin. Complications arise, and, with appropriate prenatal care and education, some can be avoided altogether.

During pregnancy and labor, so many unexpected things can happen. I don’t say this to frighten pregnant women, but to desperately try to give mothers the tools to fervently advocate for themselves…because it could possibly save countless lives.

“It could always be worse…”

*Trigger Warning: This post includes personal accounts of infant loss/stillbirth.*

In nursing school, one of the first things to which I was introduced was Maslow’s hierarchy of needs. It is presented in a pyramid, very much like the food pyramid all of us learned as children. It is designed to reflect the general movement of human motivations. At its base are physiological needs (e.g. food, water, sleep), followed by safety needs, then, at its middle, belongingness and love needs. While the middle tier is important for maintenance of psychological health, the two tiers beneath it must be addressed first.

A while ago, my husband and I were watching an episode of John Oliver. In it, he discusses our country’s current dilemma regarding sending children back to school in the middle of a pandemic. He has segments that are broken up by relevant video montages. To keep us, or maybe John Oliver, from exploding, the topic is usually a little lighter, or more humorous. The montage that night, however, made my husband and I want to throw something at the television screen.

The video was a collection of television personalities talking about how desperate they are to send their children back to school (regardless of the risk the COVID-19 pandemic poses), both for their sanity and to prevent psychological harm to their children due to lack of socialization. Each of them have wide eyes and say, in exasperation, that their children are making them crazy. While I don’t want to minimize how someone else feels, my husband and I do not agree with this sentiment.

My mantra has always been “it could always be worse.” It usually reminds me to stop and check my first-world privilege at the door. But, sometimes, the worst thing one could imagine happening actually happens. In early June, I was told that my son had no heartbeat at 33 weeks and 5 days gestation. My pregnancy had been pretty routine up to that point, with the usual discomforts, but I tried so hard not to complain, because “it could always be worse,” right? We were heartbroken, and had to deliver our sleeping child into what has become a world of silence for us.

We have a two-year-old daughter, who often breaks silence pretty efficiently, but the past twelve weeks have provided us with plenty of quiet to sit with our agonizing thoughts about why we lost our son, and the fact that things are so still right now because we couldn’t bring our newborn home. For the remainder of our lives, there will always be someone missing at the dinner table. We will never be able to physically hold our son close again, know his smile, know what he wants to be when he grows up, nor see him get married and have a family of his own. My husband and I don’t even know the color of our son’s eyes. So, we sit in the uninterrupted “peace” of our home wondering who he would have been, and what it would be like to have brought him home with us.

The loss of a child is an excruciating experience I do not wish on any parent. While some parents simply don’t have a choice but to send their children to school for one valid reason or another, it comes as a huge shock to know that so many people are so willing to risk the lives of their children for a little bit of peace. I am a registered nurse. While I have not seen, first-hand, how COVID-19 impacts its victims, I do know that it has killed children and adults, alike. It also has proven to cause lasting damage to the heart and lungs. Without a solid plan for infection prevention in place, many schools are bringing children into the physical classroom far too early and inflicting an unprecedented amount of anxiety on the teachers of our country forced to teach these classes. It is their livelihood, and offers them no other option but to risk potential exposure to a frightening disease.

As a young adult, I never envisioned that I would one day have to bury my infant son. I did not lose him to a virus, and I am not an epidemiologist. But I do know that in the coming months, without carefully-considered plans to help protect our teachers and school children, many parents may also have to give up the dreams of their child’s unfulfilled future and purchase a burial plot. Because, after all, “it could always be worse…”

If Love Could Have Saved You, You Would Have Lived Forever

My dearest, Ezra,

On a cold November night, after returning home from work, I found out that you’d be on your way. I was so excited. That was when we started to dream about who you’d be, what you’d look like, and the very first time we’d hear you cry.

All of my hopes and dreams hung on the arrival of one day: Thursday, July 9, 2020. Through all of the anxiety and fear that this year has provided, you were the bright light at the end of a very long tunnel. If I could get us all safely to that day, I felt like everything would be okay.

Today, we would’ve gone to the hospital very early, and you’d have been born just after 7AM via a repeat C-section. I was going to have something I never got with your sister: lucidity in your first hours of life. I would hold you close, and we’d head up to the eighth floor for two days of recovery.

I had it all planned out in my head. I tried so hard to do everything right. I was so careful to avoid getting sick. I did kick counts every night, and felt so much joy and hope every time I felt you move. Never could I have imagined that it wouldn’t be enough…that I couldn’t do anything to protect you.

I’m so sorry, my sweet boy. I can’t say it enough. Everyone constantly tells me that none of this was my doing. Regardless of what anyone says, I will never be able to convince myself that I didn’t miss something. Maybe I could’ve done something to save you if I had just been more astute. I failed you. My body failed you.

June 1st was never meant to be your birthday. If you’d ended up in the NICU, I could’ve managed that. Instead, I am, more often than not, at a loss for words. Your date of birth and date of death are the same day…engraved so permanently on your headstone. There are no answers to any of my questions, and the word “stillbirth” still haunts me.

Eight hours holding you will never be enough. We took 64 photographs of you that day. There are also a few photos and videos of me while I was pregnant, and your ultrasound images. These, and the memories I have of your short life, will have to be enough to last us a whole lifetime. I know it’s so much more than a lot of people get under similar circumstances, but I long for more — for the future that I envisioned long before you ever existed. I waited so long for you and your sister, and all of the hopes and dreams I had for you died with you.

I am so sorry we aren’t meeting each other today. If there was anything I could do to fix everything, I would do it. I would gladly trade you places.

I keep waiting to wake from this terrible dream. Every morning, the first thing I do is place my hand on my abdomen with the hope that you’ll still be there. And, nearly every morning, the emptiness I feel is just as immense as it was the moment you were born. I wait for a time machine, a wormhole, or a magic portal that could transport me back to a time when I could have done something to save you. Alas, no such magic exists, and I have to force myself to pick up the pieces of my broken heart and move forward.

Nobody can tell me why you couldn’t stay with us, and I don’t know what to believe, anymore. A huge part of me wants so badly to believe in a higher power, and a heaven where I will eventually meet you again. But, there are no guarantees in this life, as the last five weeks have so cruelly demonstrated, and no certainty in what happens to any of us when we leave this mortal coil. Wherever you are, I hope there is no pain, that you are happy, and that you can feel the immeasurable amount of love we have for you.

I will always be your mother. I will always be so proud of you, and the love I feel for you will never fade. Every day of my life, from this day forward, you will linger in my thoughts, and you will hold a special place in my heart.

Forever yours,

Your mama

I Would Trade 10,000 Days for One More Hour with You

*Trigger Warning: This post includes personal accounts of infant loss/stillbirth.*

It seems like the only time I feel inspired to write is when I am sad. It’s been quite a while since I last wrote anything, let alone a post to this blog. In the time I’ve been gone, I got a new job in the neonatal ICU downtown (I’ve been there for a little over 3.5 years, now), and my husband and I started a family.

Our little girl is two years old, almost three. In November of 2019, we found out that we’d be expecting another baby. We were really excited, but incredibly nervous. Then, COVID-19 happened. Home and work became very different places. My world shrank a little, and suddenly everything felt very scary, including my pregnancy.

I always have the worst-case scenario playing in the back of my brain when I’m expecting, but hope that it’s all in my head. In the very early morning of June 1st, I went in to labor and delivery triage for decreased fetal movement. At 2:20AM, and 33 weeks and 5 days gestation, I found out that my son’s heart had stopped beating. At 6:42AM, he was born asleep into a silent OR. We still don’t know what happened, but the wheels in my brain haven’t stopped turning since then.

On Father’s Day, I was offered a glass of wine at dinner. When I said “no thank you”, I was further encouraged to take it. I was a little dizzy and dehydrated from low food and fluid intake (because, I’m just not hungry, anymore, and a huge part of me feels that there’s no point in caring for myself now) and excessive crying, and all I could think about was that I should still be pregnant. Taking that glass would make all of this more real and make me feel physically worse, and that’s the last thing that I want.

What I really want is a time machine. I feel so awful, because I am a mother. I am a nurse. How is it possible that I didn’t know that my son might be in distress? Why did I go home from work that previous night? I should’ve gone in to triage after I didn’t feel him moving while I wrapped up my charting. A mother’s basic responsibility is to protect her children, and I couldn’t even do that for my son. How could I not have known something was wrong sooner?

So…that’s where I am. I am encapsulated in a silent world full of sadness. I can’t read, watch, or listen to anything without thinking about my little boy — without remembering how empty I feel. Day-to-day tasks are triggers, too, but they’re getting to be more tolerable as time passes. It’s only been 20 days, though. I had a baby…20 days ago, I had a baby, and without him here, it feels like the world keeps moving while I am stuck in that moment. Nine days ago, we buried him. None of it feels real. Every moment feels excruciatingly long. Whole days feel like an eternity, and then I have to wake up and do it again.

We’ve taken our daughter to the park a couple of times in the last week. I can’t stand to go, because I see pregnant mothers with their toddlers all of the time (that, and I’m terrified by the possibility that my daughter could contract COVID-19). I watch my daughter playing with my nephew. It makes me happy to see them smile and hear them giggle, but also sad because I will never get to see my children play together. I will never know what color my son’s eyes are, what his smile looks like, or the warmth of his tiny body against mine. There is a giant space in my daughter’s room, and at our bedside where a crib and bassinet, respectively, should have been. Two weeks from today, we would be headed in to the hospital for a planned C-section…I would be meeting him for the first time. And all I want is to hear him cry.

Most new mothers get birth certificate paperwork, infant and postpartum care discharge information, baby clothes, balloons, and messages of congratulations. What we got, instead, were: just short of nine hours to hold our son (our medical team was incredibly kind and considerate of everything we needed), stillbirth paperwork, a weighted teddy bear meant to help me sleep after my son was taken to the morgue, the option to have an autopsy, bereavement packets, post-surgical care instructions (including weight limitations…usually no more than the weight of your baby, but my son was just shy of five pounds), 32 condolence cards, 12 flower arrangements, meals from friends and family, a burial plot, a graveside committal, and the responsibility of designing a headstone. The outpouring of love and support we’ve received has been overwhelming, and there is no way we could possibly survive any of this without our family and friends. The circumstances are so incredibly unfortunate, but there are so many people surrounding us…helping to lift us from the floor.

All of the bereavement novels we’ve been gifted say that every feeling I have is completely normal. I suppose that sleeping with that weighted teddy bear every night since my son was born must be normal, too. My ninth wedding anniversary is in four days, and I wish that those babies who were wed in 2011 knew that their adventure would lead them to an unspeakable heartache. Maybe they could’ve prepared for it, anticipated it, prevented it…

When I shared that my son had passed on social media, a few people said I was brave to share that painful information. The truth, though, is that he exists. He is a person. I had already told everyone he was on his way at 24 weeks gestation. His birth did not at all go the way any of us wanted or expected, but it is his story, now. And I would be doing him a great disservice by not acknowledging him. I want the whole world to know how incredible he is, how much we love him, and how his short life has touched our hearts and changed our world forever.

Love the Half that’s Here

A long while back, I had a sweet patient who was very pleasantly confused. She would look up at me often and ask what was happening to her. I’d explain to the best of my ability, and, fortunately, she almost always had a family member at her bedside to help her pull together what memories she had left. I didn’t care for her for long, but I adored how her family addressed her memory loss.

“I feel as though I’m only half here,” she would say to her daughter. I remember she would say it quite often. “Well, we love the half that’s here,” her daughter would respond while holding her hand and smiling. So often, I care for patients who are losing their faculties, be they physical or mental (or both), secondary to their diagnoses. It breaks my heart to know that they feel something is inherently wrong with them because of the things they are no longer able to do. Being human is difficult, and it becomes especially trying toward the end of one’s life. Familial acceptance, however, of the things that they are still able to accomplish is the kind of thing that renews my faith in humanity every time I see it.

When her family would leave, they’d hug her and say, “See you later, Alligator.” She would always respond with, “After a while, Crocodile.” One day at around lunchtime, I had to give her a medication. I brought my hand up to knock on her door before entering. I paused for a couple of minutes as I heard my patient and her daughter singing “I am a Child of God” and other children’s songs.

If I were to be given one wish, it would be simple: I wish that nobody in this world ever has to traverse its stormy waters alone. Somewhere in that wish for companionship is the desire that every person might feel the acceptance of what they have to offer…even if they feel they are only “half here”.

Just a Closer Walk with Thee

Yesterday, this world lost another beautiful soul. His name is Chuck. He was the deacon and primary caretaker at St. Paul’s, the small Catholic church across the street from Boise State University’s campus. It was a quiet place to study, and a place to talk with people who were kind and accepting of you. Most of all, it was where Chuck worked and cared for members of his flock who felt lost in any other environment. His demeanor was always very gentle. He never raised his voice, and, when he talked to you, he always looked you in the eye with an almost palpable level of compassion. Everything you said mattered. He was constantly, actively listening to the things that his students said, and decoding the things that they meant to say.

In the last couple of years, he has battled Lymphoma. His family has chronicled his trips to and from the local hospital, as well as experimental treatments on the East Coast. Just two days ago, his niece wrote a post onto his support page on Facebook. She said that he was now a “DNR” (a change in a patient’s code status at the hospital; an indication that he doesn’t want extreme measures taken should his heart stop, or should he stop breathing) after doctors said that chemotherapy was no longer working, and that they didn’t believe there was anything more that could be done. In my gut, I had a feeling that he had been made what we call a “comfort care” patient at the hospital. These patients are given more frequent and higher doses of pain medication for the sake of comfort, as well as other forms of medication to treat exacerbated symptoms considered normal at the end of life. All other treatment is usually suspended at that point in time. I didn’t ask further, because I figured it wouldn’t be an appropriate question for the family at this delicate time, but I had a sincere feeling of dread.

Yesterday morning, I made a point of not getting onto social media. When I finally did look at Facebook later in the day, it was filled with heartfelt posts from those who knew him…about his passing.

I could have guessed which hospital he was in, or what floor he was on, because I work there. There were so many times I could have visited him in the hospital because his family had notified people he was there, and he was only just down the hall from my group of patients. But, when the room is dark, and the door is closed, something tells people (especially nurses) that the person inside is tired, in pain, and just wants the opportunity to rest.

Chuck was one of the kindest souls I have ever had the privilege of knowing. He would always make time for anyone in need. His homilies were always gracious, gentle, and delivered as if telling a story to a small child without being patronizing or demeaning. His two daughters adored him, and his wife, Rosie, is sweet and just as patient as he was. He would tell me about how they met as neighbors in their childhoods, just down the street from where he would eventually be a deacon. I do not know how old he was, but I do know that he left this world before anyone expected him to do so.

My heart aches to know that he is gone, and an entire community is now mourning his loss. I wonder if he knows how many lives he touched, and exactly how much he will be missed.

All I Could Do Was Cry

There’s no hiding the fact that, occasionally, I will lose a patient at work. It’s to be expected in a hospital setting, but that doesn’t make it any easier for anyone. I know how sappy I sound when I say that I watch shows like Grey’s Anatomy, or Call the Midwife. The weird thing is that they speak to me. They depict real situations, and add dialogue to that which I have such a hard time describing.

Recently, on Grey’s Anatomy, there was a story line about personal loss in one of the doctors’ lives. The monologue usually has a similar theme every week, with an expected rhythm. The show is, more or less, a soap opera, after all. This time, though, it hit a nerve. For whatever reason, the following words mean something more to me than they would have before I started working as a medical-surgical nurse:

“There’s a thing we say when someone dies. We say it to the patient’s family. We say, ‘I’m sorry for your loss.’ It’s a pat little phrase, and an empty one. It doesn’t begin to cover what’s actually happening to them. It lets us empathize without forcing us to feel their devastation, ourselves. It protects us from feeling the pain: that dark, sinking, relentless pain; the kind that can eat you alive. And, every day, I thank God for that. We can’t get too close. If we felt even a little of the love, and the joy, and the hopes that our patients are saying goodbye to, we’d never be able to function. So, we say, ‘We’re sorry for your loss.’ And we hope it offers something: some little bit of support, some bit of peace, some bit of closure, something good, some little bit of beauty in the midst of someplace dark, an unexpected gift just when it’s needed most.”

Grey’s Anatomy, April Kepner’s monologue from All I Could Do Was Cry

Family members are so invested in the patient’s care, sometimes. It’s a little maddening when they try to be too involved, but it’s understandable. When your husband is in the hospital, you want him to be okay, in the end. When your mother is sick, you want her care to be excellent. Why? It’s because we invest so much of our lives in the lives of others.

I once saw this documentary about “The Falling Man” of 9/11. It’s a photograph that came out in a newspaper the day following the tragedy of a man falling from one of the towers. There was footage from that day, and an interview came across of a woman looking for her husband. She was sobbing. Then, she said, “It took me so long to find him. He can’t possibly be gone. I can’t start all over, again.”

It is part of the human condition to search for and reach out to others. We cling to one another to get through life. Without the support, we would be unable to cope with the physical and emotional pain the outside world inflicts. Once we have thoroughly invested our lives in those of others, unexpected situations like strokes, heart attacks, a new cancer diagnosis, or even expected tragedies like the natural end to someone’s life, make us feel thoroughly powerless.

When my grandmother died, there wasn’t a dry eye in the whole house, but it was so quiet. Eventually, my grandmother was taken from her house to the funeral home. As she was wheeled out the door, my level-headed, composed aunt started to cry very audibly, and she collapsed to the floor. I have a hard time describing it in words, but it is my own somewhat violent, physical representation of everything my patients’ families must be feeling.

The loss I feel as a nurse is a very distant one. It really has to be, in order for me to maintain composure enough to care for five other souls for the rest of the night, but the pain is still palpable. I talk about death an awful lot. It seems morbid, but death is a part of life. Inevitably, every one of us is going to die. And every life lost leaves a painful void. Sometimes, the only thing we know how to do is cry. Sometimes, the only thing we can say is, “I’m sorry for your loss.”

Failure to Thrive

I’ve been working in a hospital for about three months, now. Half of that has been with a preceptor, so the time spent working by myself has been rather brief. In that three months, I have witnessed death, frustration, anxiety, love, support, hope…and just about every emotion in-between. It has been an education for me, and it can sometimes be extremely overwhelming; it feels a bit like my head might explode with all of the information I force into it.

As a student, I have never been quick to pick up new information and run with it. I wrestle with facts and figures until they finally stick; that process usually takes a long while, though. Lord knows, I still have some difficulty understanding the significance of some of my patients’ more obscure labs when I analyze them. My head is constantly full of tasks to be done, medications to be administered, cares to be considered and planned into my night, and I feel so slow. When giving report to another nurse, or to the charge nurse, I can tell a patient’s story, but the little details that can have so much meaning sometimes get away from me. Who am I kidding? There’s ALWAYS some small detail that disappears into the ether, regardless of its importance. The “big picture” seems constantly obscured.

I’m still waiting for the day when starting an IV or Foley catheter don’t frighten me. I’m praying for the day when my heart stops racing as I step into the elevator that climbs up to my floor. I give myself pep talks in the car, on the way to the hospital. I say prayers as the elevator jolts me upward. Mostly, I pray that I don’t fail, and that I do as much good during my shift as is possible.

Today, I went to a class meant to promote improvements in the patient experience and to prevent infection of central lines and urinary tracts (as a result of catheter use). There’s so much to remember, and there’s a policy for everything. That is both a comfort and a confusion, seeing as there is so much to be done for six people in the course of 12 hours. The class was helpful, but still a reminder of how far I have to go.

Everyone says the first year is difficult. Some of my preceptors say they still have anxiety attacks on their way to work. A couple of nurses have said they still feel scattered and frazzled at work after 20 years of experience. All of this makes me wonder about people who are really, genuinely busy. Take our president, for example. His role in this country is so much more important than mine. He’s dealing, simultaneously, with our petty problems and some of the more horrific issues faced by those in the rest of the world. I don’t know how early he gets up in the morning — and I know he has help — but it’s no wonder one president is limited to two terms. A day more than that has the potential to kill a person on the spot. I think a 12-hour shift is long. Try eight years before the sun comes up, and the president can hand off all of his duties to someone else. Then, there are those in this world who use their ingenuity to make the lives of others better, despite, and in addition to, very busy lives.

I can’t say that I’m like those people. I work a couple of days, and I need my time off to recover. I’m constantly tired, and some of the things I witness while working make me want to cry. How others have the ability to raise families, work full-time jobs, and still have the energy to do something meaningful for their fellow man is baffling to me. I barely have the motivation to call my dentist to schedule an appointment.

There will come a day when I feel a little less like a failure. There will be a day when I can see and feel myself growing as a person, and as a nurse. I don’t know when, but, as long as the hospital is willing to work through my growing pains, I will do my utmost to continue to grow. I refuse to accept “failure to thrive” as a diagnosis for my career, and for my life.