Tuesday, October 25, 2011

Actively Dying

The group of students walking behind me move uneasily through the bustling hospital halls. Their crisp clean coats stand in stark contrast to the faded linoleum and stained wallpaper. Doctors and nurses dart quickly to avoid slowing down behind the ambling herd.

I pause for a moment at the end of the hall, think better of it, and walk on. I turn quickly toward the group as my legs propel me forward mechanically. Our next stop is just three doors away. I check to make sure the hallway is empty before addressing the group.

I think we'll skip room 214. She's "actively dying."

A few steps later, it dawns on me that such a term is likely confusing to a third year student. I stop abruptly in front of our next patients room.

So who can tell me the definition of "actively dying"?

The row of faces look up quizzically, but I am already lost in thought.


My mom's voice sounded shaky over the phone. I could hear my grandmother breathing heavily in the background. Her silence spoke volumes. I adjusted the receiver and took a deep breath.

How's she doing?

My mom's answer was almost imperceptible. I felt, for a moment, like I was talking to a child.


I strained to interpret her uneasiness as I calculated the distance between St. Louis and Chicago. If I left immediately, I could reach the assisted living in six hours.

Is she still talking to you?

Instead of answering, my mother lifted the phone to my grandma's ear and coaxed her to speak. I listened to each struggling gasp. The prolonged breaths were punctuated by pauses.

My mind clicked. As a second year resident, I'd dealt with this before. I slammed down the phone and rushed to my bedroom to pack a few things before leaving the house.

The roads were dark as I sped down the highway.

Time was running out.


Six hours later, I walked into my grandmother's room. I was oblivious to the grime and sweat caked on my body. I had driven all night. I knelt next to the bed and placed her hand in mine. My mother and father sat quietly in the corner.

Her breathing had slowed since the night before. The pauses were more apparent. I leaned over and kissed her forehead. I whispered into her ear.

It's OK. You can go now!

I placed the radio on the nightstand and put on the My Fair Lady CD.

Grandma's chest moved up and down slowly with the rhythm. Each rise and fall more gentle till the energy in the room palpably changed.

Her body was still.

Her soul had left us.


After a reflective moment, I answer my own question.

"Actively dying" is the final phase of life. The short interlude in which the dying process takes place. It often lasts between twelve and twenty four hours. Patients are usually unconscious and exhibit cheyne stokes breathing.

I can see the puzzlement wash over the student's faces. A few raise their hands as if we are in a classroom. One speaks up.

So what do we do when this happens?

The first thing that comes to mind is my mom's face. She still can't talk about that day without breaking into tears.

We comfort the family.

They are the ones who will carry the scars.

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