Decision

I saw a woman in the grocery store today. She looked at me like she thought she might know me, gave a small smile and nod without saying anything.

I knew exactly who she was.

When I was very pregnant with Bea, I took care of her husband.

I remember the night he came in. I got his admission packet before he arrived, scanned it for diagnoses, meds, tried to troubleshoot any problems, anticipate his needs, be ready for him.

Something jumped out at me while reading his packet; almost all of the narrative notes referred to him as "lovely man".

He was smiling as he was wheeled in and brought to his room. I followed close behind clutching my stack of paperwork, ready to tackle the chunk of work it is to admit a patient.

He'd had cancer years before, and thought he'd beaten it. It came back, and he came to us post op, having had a mass removed from his abdomen. A perfectly healthy looking 60ish year old man, Ken would quickly show me what made all those writers refer to him as lovely.

He sat on his bed, relaxed, cross legged and answered my dozens of questions, signed my dozen consent forms, with a smile on his face. I sometimes dread the head to toe check, especially on an alert and oriented young person, but he eased my mind, explaining that he'd abandoned any sense of dignity after hundreds of physicals while in the army, let alone being treated for cancer.

As I inspected every inch of his body, he told me about his hobbies, he loved the woods and the water, fishing, Vegas, watching sports.

He'd been making little leather change purses to keep his hands busy, he handed me a bunch to give the staff on the floor.

He gushed about his wife, how lucky and happy he was to have her. She showed up later that evening, just as pleasant and easy going as her husband.

For the next few weeks, I'd find myself looking forward to seeing Ken and his wife. Both of them just nice to talk to and always appreciative of every little thing we were doing for them.

He always denied pain; even with my finely tuned nurse radar, I couldn't sense any discomfort. He didn't take so much as a Tylenol. His wound healed up without incident, he looked forward to going home and carrying on with life. We were all sure he'd get to do just that.

On a Wednesday, I got to work just as Ken and his wife were returning from his Oncology appointment. She let Ken go to his room and cornered me in the hall.

Ken had around 6 weeks. Not what they'd expected to learn.

She asked about Hospice, what it entails. I assured her that we had time to get everything in place, I'd put a call out and they'd be in the next day. She wanted to know what the end would be like. All I could do was tell her that he would be as comfortable as possible, but no need to discuss that now. He was showing no signs that he was dying, we had time.

Ken's wife left and I went to see how Ken was doing. He was still smiling;

"I'm going to die tonight."

"Come on. Look at you. I know dying people, you're not going anywhere tonight."

"Nope. I've decided. It's going to be tonight." A firm nod and a twinkle in his eye.

I sat down on his bed. Nurses aren't supposed to do this you know. It's against the rules. I love when a situation presents itself that demands I break those stupid rules.

I took his hand;

"Fine. You say you're going tonight, I have to believe you. But. Since I'm you're nurse, you just put me in charge of your send off. I'm getting orders for Morphine and Ativan and anything else I can get my hands on. You look at me funny and you're getting drugs ok?"

He agreed.

I was thankful that the doctor on call was a woman, I don't know if a man would have gotten what I had to say. I explained to this doctor that Ken looked in no way like he was dying, but he insisted he was, so I wanted orders.

She gave me what I wanted.

I updated Ken on his orders, gave him the list of what he could have and when and offered to call his wife.

"I said my goodbyes. I'm ready. So what can I have again? Morphine? That sounds like fun, I'll have some of that."

He had to tell me he was in pain to get it, I didn't know or care if he was lying. The little amount I gave him made him very happy.

The rest of the shift passed without any change in Ken. He dozed, watched TV, we chatted when I had time.

When my shift was over, I went to say goodbye. I sat on his bed again, took his hand again.

I think I've mentioned before, that feeling of being in the presence of the end of a life while a new life is trying to kick its way out. That feeling of straddling the two worlds. If you ever get the chance to experience that, I highly recommend it.

He hugged me and told me that he loved me. I'm pretty sure I told him the same. Those words weren't like the "I love yous" exchanged between family or friends. Just humans. I said my goodbye, sure I was going to see him again in a couple days.

He slipped away in the wee hours of the morning.

I was shocked to hear it. And so happy for Ken. So many choices were made for him, he didn't have any say, but he got to make that final call.

He made his decision, the most important one, and stuck to it.