I wasn't even that nice. What are we doing to each other?

death, like the hungry bear in autumn

A patient died on our floor today.

The first time I saw her was as she was dying.

I was sitting a few doors away and only half-listening to the nurse talking to her.

"Hey. Susie. Pay attention."

I clicked through my charts.

"Susie, stay with me. Susie. Are you ignoring me or just looking up?

Assuming the nurse was talking with another patient who'd been particularly stubborn, I continued charting.

"SUSIE!"

I took my hand away from the mouse.

"Help!"

I stood up.

"SUSIE! WAKE UP! STAY WITH ME! STAY WITH ME!"

I ran to the room. The patient, an enormous woman, was seated on the commode. Her face was purple and her gaze fixed upward to a ceiling tile.

Another nurse joined me and the three of us fumbled with the emergency buttons on our badges. "Which one is staff emergency?!" we asked each other. "I'm pressing all of them!" the first nurse declared, likely canceling out our collective efforts.

No one came.

We pressed more buttons. Alarms were going off. Suddenly the room was filled with frantic elbows and feet.

I grabbed the crash cart. I tried to push her bedside table into the bathroom to make space for the staff and equipment, but my mission was blocked by the confusion of bodies. "Excuse me, sorry, hey, I need to get through..." I heard myself say. Why couldn't I drop the politeness, just once?

Meanwhile, the woman was dying.

More people flooded in.

"Is she a DNAR?" (Are we allowed to try to bring her back, or does she wish to let nature take its course?)

No one was certain. Someone went to grab her chart. "No! She's not!"

We had our cue to revive her, but she was still on the commode. How to get a gigantic lady from her toilet to her bed? "We need some muscle!" Dale, the only male in sight (and an aging, slender one at that) was called forward. Seven, eight, nine nurses swarmed like ants around her. I saw her tumbled face-first over her oxygen and IV cords. Still more staff were arriving. I had to leave. I knew the best thing I could do was to make sure the rest of the floor was clueless to the chaos.

I saw onlookers standing outside of the family room. They seemed oddly transfixed on the hustling occurring outside of the room. I asked if I could help them. Breaking the trance, their spokesperson stated he was the son of this patient.

Oh shit.

I told them that we had every capable hand in the room, including two physicians.

I promised him that I'd give an update when I could and would let the nurse know where they were.

And then I walked away.

We aren't trained how to handle crisis. It's interesting watching how other people react. Some of the most confident nurses freeze up like arthritic jello. I seem to step outside of myself and feel tense yet oddly rational-- a higher dose of sensibility than I otherwise possess.

We also aren't trained how to talk about crisis. Or death.

A while later, I went back to the room. There was still a lot of commotion around the doorway, but I wanted to keep the promise I'd made to the son.

"They just called it," one of the nurses said. Her eyes were welling up.

"She's dead?" I asked.

She nodded her head.

"Her family is in the waiting room..."

As soon as one of the physicians heard this, he headed for them.

He met them in the hallway.

"Are you her relatives?"

I went to go turn the light on in our conference room.

"I'm Doctor X."

I tried to think of the most polite way to suggest that they head to a room.

"She didn't make it."

I froze. 

So. That's how it's done. 

Later, I saw that orange juice and ice water had been brought to the room. I don't know what the doctors went over with them. What sort of things you discuss when there's one fact you are not comprehending. They were there a long while.