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Life is like the morning fog

Dear diary,

I have a patient today, whose story is one of those that makes you wonder why terrible things happen to good people. She is only in her sixties, and she was a healthy, normal functioning woman living a simple life. She’s had lots of family in and out. Friends too. You could tell she’d impacted many people in her life and her absence was noticed.

She was a biker. She’d ride all over her neighborhood. One night, not too long ago, she was biking home, and it’s unknown how it happened, but she was thrown off of her bike and suffered quite a few injuries. She was admitted to the hospital and cared for accordingly.

When a patient is involved in a fall, we address the immediately affected area, but we also want to assess for any trace of a head injury. Head injuries are silent killers. They can go undetected for extended periods of time. The signs and symptoms aren’t always apparent, and left unattended to, they will cause irreversible deficits or death.

Remember Natasha Richardson? She played the mom in The Parent Trap (one of my personal favorites). She passed back in 2009 due to a brain bleed she’d obtained while skiing. She was without a helmet when she fell. Initially, she had laughed it off and wouldn’t allow any aid to be provided. That same day, she’d started to feel off, and ended up seeking out medical help. She died not too long after.

In my patient’s case, she suffered from a leg and hip injury, but also, very serious head trauma. The damage it caused…it’s heartbreaking. She can no longer walk, bike, talk, or move her limbs. She doesn’t eat. There’s a healing incision across the top of her half-shaved head. The part…(even typing this is emotional), the part of this tragic story that I struggle with, is that she is still fully aware. She is awake, knows who she is, where she is, and that her life is now completely different. The extent of her communication is nodding to yes or no questions.

At some point in our lives, we are urged to complete advance directives. Basically, how do you wish to be cared for once you become incapacitated? Have you appointed a healthcare proxy to make those decisions for you, in the event that you cannot? Or, have you written a “living will” which gives us a specific plan of care, for you, when nearing end-of-life? My patient was very proactive in regards to this. In her living will, she did not wish to suffer. No feeding tubes; no prolonging measures. Instead, she gets small bites of ice cream, swabs dipped in coffee or water and she is currently on a medication drip to keep her comfortable.

It’s been a few days now, and I’m wondering how she’s doing. I’ve done a lot of thinking since my last shift with her. Mostly as it relates to life and how precious it is. Every minute, heck, every second MATTERS because my patient’s life changed in a few seconds.

The Bible (I’m a Christian), says this,”how do you know what your life will be like tomorrow? Your life is like the morning fog — it’s here a little while, then it’s gone” (James 4:14). Now, whether you are a believer or not, what the verse is trying to convey is no secret. Life is unpredictable. It’s a vapor, a fog, a gust of wind. One moment it’s here, and in that same moment, it can be taken away.

We could spend a lot of time thinking about how fleeting it is, but being in that headspace only delays what we do next. Sure, let’s not forget about that principle, but I think God’s intention for that verse was to wake people up. Don’t assume your plans will unravel the way you want them to; don’t be so set in your ways that you’re unable to adapt to the inevitable disappointments in life.

My last interaction with my patient was hard. I had asked a few yes or no questions to ensure she was taken care of before I left for the night. She agreed to having her mouth cleaned and as I was doing so, she had tears streaming down her face. I stopped, thinking I’d done something that caused discomfort. It wasn’t that. It wan’t anything I was asking. I looked into her eyes and I could feel her sadness. A month prior to that, I bet she never, in her wildest dreams, thought she’d be in this predicament. I felt for her and all I could do was be present in that moment. I couldn’t tell her she’d get better. I couldn’t tell her to hold on and fight. Instead, I told her I was praying for her and that I was honored to have been her nurse. She cracked a half smile and THEN, she squeezed my hand. The deficits were extensive, but somehow, her mobility in that hand was intact and she had the strength to let me know.

Let’s make a promise to ourselves to stop taking each day for granted. Everything we could ever do, experience, see, own, or create is a blessing. Don’t let another day go by where you hold yourself back from something or someone. Don’t let another day go by and you still have anger, hate, resentment, jealousy, or unforgiveness in your heart. Don’t let another day go by where your fears and need for security cause you to become stagnant. Don’t be reckless and haphazard with your lifestyle, but walk out each day in wisdom and with thankfulness that you’re here and still have so much in store.

Here’s to my patient. Here’s to every person whose life came up short. I carry you in my heart and I will give this life everything I’ve got. Reminder, we only get one, so let’s live it well.

-RN

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