Music: Life is a Bittersweet Waltz, by Leon Redbone
"With all of its' glories, and all of its' faults, it seems life is a bittersweet waltz."
I sat today with an dying man, and I fed him with an eye-dropper. He has not been eating enough to keep a bird alive, and so we have resorted to tricks used to actually keep birds alive. He is tiny now, shrinking daily, has trouble drinking liquids and prefers to spend his time sleeping. Today, his blood pressure began to fall, and he began shivering. I covered him up quickly with a blanket and held his hands for a moment, and then I took his blood pressure, heart rate, respiration. "Talk to me. Tell me a story." He opened his eyes, and smiled at me, a lop-sided smile. Bell's Palsy has made the other side of his face droop. In the few weeks I've been treating him, I've come to love the little lopsided grin, the bald head, how he lifts his eyebrows when he recognizes me. "Come on now. Be a gentleman. Don't leave me alone on the dance floor." I tease him as I take his blood pressure. "We need to lay him down now, it will help his blood pressure come back up," I call to his granddaughter, who is caring for this elderly man and his wife. Both need care around the clock.
Over the weeks, I've had gentle talks with the granddaughter. She is carrying a heavy load, carrying for a special-needs son as well as her grandparents. Both are confused, and need moment to moment direction in all tasks. I see both for physical therapy, and it is a task. The granddaughter does not get a break, and has been getting little sleep.
I have talked to her gently about options for care, trying to ease her mind while trying to ease her burden. Today, we go further, and discuss discharge from restorative care to palliative care. Although I am more practiced now talking to family members about end of life issues, it is never easy. I am not ashamed to say I cry with them, I can't help it. No one cries alone in my presence. There are times when human touch and a shoulder to cry on are all I can truly give. If they want me to pray with them, I pray with them. If they want to talk and cry, I let them talk and cry it out. People need loving support in these decisions, they need to know it is okay to choose hospice, that they have not failed as family members. Today, the admission that things are not going to get much better, and comfort and joy, in the time that is left, should be the only goal.
We ease the tiny man into bed, his alertness changes moment to moment. I take his vital signs again, and discuss monitoring issues with his caregiver. Rather suddenly, he stops talking. "Is he okay?" She peers anxiously. Without showing alarm, I check his pulse, and stick my stethoscope in my ears for a breathing check and blood pressure.I touch his check and rub his sternum. His breathing is shallow, and suddenly he opens his eyes. He had fallen asleep. His granddaughter and I both started laughing, our cheeks wet from tears moments ago.
She seems at peace with the decision, and as I leave we hug. "Thank you. Thank you for everything," she said. I feel I have done little, except listen and support. "You bet," I replied. "This is why I'm here."
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