rosary

the man in nine
with his rosary
clung to life
alone , was he

words we spoke,
not for him
but for us;
his time grows thin

death isn't clear
like red and green
the man in the bed
somewhere between

here we are
there he lay
the end of his time on earth
might be today



This week which isn't over quite yet but deserves and early entry, has been the most interesting and different week. It's still part of family med, which I've learned can be quite the model of inefficiency and prolongation but the palliative and transitions team is something special and unique. They are the doctors, NPs, PAs, nurses and all staff who help care for those people who are nearing death and their family/friends. they are among the most humble people and really there is not other way to approach it. here, medical professionals admit medicine has failed and that a patient will likely get worse or pass or remain in some kind of poor state. here, we rationalize and plead with families to consider code statuses and try to prepare them for the end, or perhaps the beginning, death.

My first day, I quip was the day I donned a black robe and scythe. For one reason or another, 5 patients passed on the team I was on. Just that morning, I went with the NP to go and try to have the family consider changing code status and help them help their loved one. Something divine occured as a code was called for a man who I can only describe as being totally intractable to pressors , very hypotensive. I remained in the room in the code and was told to glove up for compressions and before I could rotate in, death was pronounced at 1023a, monday morning. It was the first time that I saw someone pass , in front of me and somewhat dramatically. Sure , I've been in traumas where someone has passed but on that service, it's almost like the actual passing occurs outside the sight and interest of the the team. Here, death is very much part of your day. Then as that family was consoled, there was a weaning of a vent in another room with a man with cancer history and he passed shortly. A very different, accepting family had said their goodbyes and allowed us to do his final examination. To actually appreciate that this man has no pulse, no heartbeat, no respirations, no response to pain... and only has agonal gasps.. really is humbling....

Yesterday wasn't as eventful which is both good and bad. In medicine, uneventful might equal a slow long day but it also means people are living. This again.. can launch a whole conversation on "living". I would venture to argue , to say.. that not a whole lot of people are "living" very well in the hospital. It really is a bad place for a lot of people. Today, I prayed with the Palliative team for a lady whose family was changing her code status to DNR and basic comfort measure. Per the family, I learned of a charming wizened lady who was in her yard , planting trees only days ago and was highly independent. It's not unusual to see your own family members in these families and to feel close to them. Again, at one point the family laughed at the idea that I would get hit by the door as they awaited another brother and then we held hands minutes later.

I suppose I've learned that not everything can be fixed, contrary to what a surgeon might tell you.. haha. Healthcare workers are mortals but we also can work in concert with God's will... it's unique to be on the Palliative team....

-Robert