At the End

The memory I struggle with most is the final moments at the hospital.

We had spent a few hours in the ER – which in our world, wasn’t uncommon. The medical staff were concerned but we had been in that position so many times before that we had grown complacent, I think, and didn’t fully recognize the danger. The boy was alert and while not comfortable, was doing OK, still answering questions and cracking jokes.

He spiked a fever shortly after we arrived and they began IV antibiotics. This seemed to help. The fever went down shortly afterward and was low again by the time his doc showed (an uncommon occurrence in the ER, judging from the surprised reactions). The doc began delving into the chart, reviewing and adjusting orders. We talked as he was working – some of it medical and some personal, as always. The next sign of real trouble arrived while he was still there – falling blood pressure. He ordered fluids, which seemed to help, and shifted the bed the boy had been destined for to the ICU, before departing.

The boy was doing worse by the time they moved him – so much so that all jokes and conversation had stopped. I traveled with them to the ICU and waited obediently as they went to settle him in his room. It was only a minute or two later that I heard them call the code and recognized the room number.

They let me in and I watched the swarm of doctors and nurses working – hurrying to follow instructions and occasionally offering suggestions. I answered questions as I tried to stay out of the way: no compressions, no intubation – he didn’t want to wake up on a ventilator. They restarted his heart with epi and I started to hope but the rhythm ended. At some point they moved me closer so I could hold his hand and told me to speak to him. All I could think to say was “I’m here. You aren’t alone. I’m here”. I wanted to tell him to stay but I knew that wasn’t fair so I just let him hear my voice, hoping it would anchor him. They worked for a while without success. Eventually the head doc looked to me for permission and I nodded. But as they started to back away, the boy moved and they discovered a pulse so the dance began again. They got another rhythm and lost it. I’m not sure how many times. In the end they used an ultrasound to check his heart. I don’t know if they were trying to convince me or themselves that he was gone. I joked to the boy that they seemed to be checking to see if he was pregnant – dark humor, unheard by it’s intended audience. He would have smiled if he’d been with me. I watched his heart on the monitor, when they found it, but it was the doctor’s eyes more than the screen that told me what I needed to know. I nodded again. This time we were done.

As they cleared the room, someone asked me who to call. It wasn’t the first time but I’d put them off before. It wasn’t a priority. I considered driving myself home – it wasn’t far – but I gave in and picked a number from my phone. A good friend who lived near by.

Nobody tried to send me out. They brought me a bench and I sat holding his hand and watching his face – eyes still open but empty now, mouth agape. I wondered if I should close his mouth and eyes. I wish I had now because that’s the face I see at night when I can’t sleep – fragile, staring, and empty. I stayed until I was able to believe he was gone – until his body literally started to grow cold. It felt important.

The hospital’s chaplain sat with me – not sure what to offer an atheist. When I was ready she took me to a quiet room and we waited for my friend to arrive. She gave us a list of funeral homes and explained I’d need to make a decision soon but it could wait until tomorrow. She talked about would happen next and asked if I wanted an autopsy. I couldn’t see the point. I don’t remember much more of that night – other than lying in bed, drifting out and in, remembering the awful truth each time and seeing the boy’s face in death.

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