The connection of letting go

I’m holding his hands in mine, and quietly telling him to squeeze; I do not need to be a mind reader to know what he is thinking

He’s looking at me. Eyes that have seen twice the years that mine have bore into mine — trusting me, hoping that I am capable, that I take my craft seriously, that I am competent.

His inability to articulate the thoughts that run through his mind as I evaluate the weakness on his left side fill him with frustration. But he’s an old man, and old men can handle frustration.

I do not need to be a mind reader to know what he is thinking. People his age have survived parents, siblings, friends, and even children who have lived full lives and died in their seventies.

He knows that this is it, his run is over, and it is his turn. His eyes betray the outward calmness though; no man that holds even a trace of lucidity can face his own demise without trepidation. His eyes tell me what I already know. He wants to live, even if for just another minute, preferably a day, maybe another season, perhaps one more Christmas.

No other choice

And I am here to make it so. He has to believe in me; he has no other choice, there is nobody else. All of the people he has known — the children he has raised, friends, lovers, teammates — all come together in this moment. And it’s me he shares his final moments with, sucking oxygen from the non-re-breather, flinching when I stick his skin with a 20 gauge catheter, letting me attach the leads, trying to squeeze both of my hands when I tell him, smiling a half-smile when I ask.

I call the hospital and relay to them the events that have transpired, and they decide that he is not a candidate for tPA. At least three hours have passed since the first sign of CVA symptoms, and I wonder if I should have stretched the truth and told the person at the end of the line that the patient was fine two hours ago, and not five, like his son had told me when I responded to their home.

So it’s the two of us now, his son following close behind, even though I asked him not to. The IV is running, the 02 is flowing, his rhythm is erratic and I have done all I can do for now. The captain’s chair sits empty and the report will have to wait — because I have clicked off the phone, put down my pen, and am holding his hands in mine quietly telling him to squeeze.

The final moments

He closes his eyes but the connection between us remains, and I don’t let go until I have to.

His heart stops soon after we arrive at the ER, and a trauma room full of people are at his side. His family waits outside the door as CPR, epi, and more epi, then atropine and whatever else they see fit to revive him is pushed through his veins. But nothing works; he is pronounced dead at 21:52, some 95 years after he was born.

I take a moment before going in service, and think of how fortunate I am to have the ability and opportunity to do what I do.

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