When You Lose

You get used to seeing your frequent flyers, knowing their idiosyncrasies, learning their stories, sharing in their pain and struggle and once they are gone it almost leaves and empty void.  We lost one of those a couple of weeks ago, and I’m still dealing with it as it hit far too close to home.

Part of that was she was young.  My age young.  My wife’s age young.  With a family, children, hopes and dreams.  Another part was that we had brought her back once before.  The progression of her disease was insidious, things compounding into one another, each adding to the vicious cycle, adding momentum, gaining speed as she careened towards the final dance.  The heart failure brought about due to peripartum cardiomyopathy got worse.   The ray of hope that a heart transplant provided was shut out as her kidneys failed and the transplant folks never accepted her inability to lose those last 10 pounds.  I don’t think they realized that losing weight requires exercise and that it’s near impossible to exercise when your ejection fraction is 15%.

She had been on our floor for some time, then went to the ICU as she was no longer stable enough to be with us.  Dialysis at the bedside, levophed to keep her blood pressure high enough to perfuse the brain and what was left of her heart.  She told one of the aides that she wanted to come out to us, instead of our sister floor, when it was time to leave the ICU.  Her kids would come to visit, family too.  And finally it was enough.  She decided that she was done.  She was done with the fight that she had been fighting for so long.  How much of her youth had been spent dealing with this disease?  How much time away from her family had it robbed from her?  She had spent more time in the hospital this year than she spent at home.  So without telling anyone except the docs and nurses, she stopped everything and slipped away.  Selfish?  Maybe.  Maybe it was the action of someone who was just done.

I came back from time off and noticed that the location was no longer next to her name…never a good sign when someone was as sick as she was.  I asked and learned the truth.  I played with the idea of going to her service, but felt odd about it.  It didn’t feel right to intrude upon her family’s’ grieving in that fashion.  I still managed to say good-bye in my own way.

As a health-care provider, death is around us all the time.  I’ve eliucidated my views on death many times, and believe that it is a part of our journey, but when it happens to someone that you know, someone that you’ve taken care of, someone whose life you’ve saved, someone who is close in age to the wife you love, it hits far too close.  I know that she is somewhere better, freed from the shackles of her disease, resting peacefully now.

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