This is kind of a sad post so if you are sad you may want to skip it. It is about the very downside of my work. Sometimes I need a way to remember life lessons and this blog works as well as anything else.
One of the most humbling things about working with the elderly is that you are there to work with them, help them recover or function at their best, and yet you learn so much. I've been fascinated this week with the story a patient was telling me about eloping to be married and keeping it secret for an extended time. The neat part is that she did this one year before my grandparents did the exact same thing one year later, and in the exact same place. I cannot wait to learn more.
But today I figured out the lesson another woman has. This woman is dying. She has had many, many serious problems for a very long time and knew she would not live much longer. She has always bounced back. However, a series of recent illnesses led her to decide no further treatments and she went on hospice. One of her problems is absolutely fatal without treatment so she knew it would not be long, often just a few days.
Death is generally very, very peaceful. Although I'm sure I do not remember every patient I've been around because there are too many, I remember only 2 that were close to this horrible. One of those patients had cancer that had invaded her spinal column causing nerve pain that was hard to control, but it did become controlled after a few days. The other choked to death at dinner, requiring CPR. CPR is not fun to see.
But this lady now is tough. In fact she is too tough. Death does not seem to happen until the person really lets go and this lady just keeps hanging on. It is so awful to watch I've had nightmares about it and ask daily as soon as I arrive "did Elaine die?". It is exactly what I used to think death was. Until the last few days she has yelled and moaned and cried. Usually they can pretty accurately guess when death is near; she has reached that point several times, yet she keeps going on. To my knowledge she has had no nutrition or fluids in a week or more. Even more amazing is that from the things I usually look at to guess if death is really close, she may still go on for a while. Her breathing does not indicate imminent death, nor does her color. She wants to die, she'll say so and plead to do so, but she's not really letting go.
Thinking about her today I realized that I've always had the wrong idea about something. I thought "the tougher the better". It's basically the same thing I wrote about yesterday, where I am very slowly learning that pushing myself to the edge of my ability to cope is not happening. But this is a horrible, horrible, visual of why sometimes it is best to let go.
Sometimes tough is very, very bad.