Wednesday, January 4, 2012

On The Dying


On my last shift, I was called to intubate patients in respiratory distress. One of each gender. One had advanced leukemia, just had a chemo dose, was on dialysis  and coded. Began to bleed above and below on the GI tract.  When I arrived they were doing chest compressions and soaking up towels full of blood in the mouth to make it so they could mask ventilate. Energetically, I wondered why we were all here. Patient was gone. I could not feel its presence in the room. It was gone. Just gone. There was no time for Reiki, just a lot of airway management. Going through the Difficult Airway Algorithm. The ER doc who was running the code wanted an endotracheal tube. I got an LMA, but had to keep going. Once the FastTrach was in, the ER doc called the code.  It was medico legal anesthesia. I wrote a note for the chart. I did not charge a fee or submit it to billing. It was my skills actually, and a half-hour of my time, struggling. I got so messy even on my gown, mask, and gloves I wanted to go take a shower after. But I cannot bill for my services for that. It is too sad.

The other was a reintubation. End stage alcoholic cirrhosis gone hepato-renal on continuous veno-venous hemodialysis.  Two poles with pumps and a ton of drips. I got a 7.5 mm endotracheal tube in once they pulled the old one out under my direct view. It wasn't easy. The one put in at 1:30 a.m. had developed  a cuff leak. This patient did fine, and had no insurance. For that one, I did bill, as our group combines the units.  The first thing I asked in this room, is 'where is the family?'.  I was told this was the first time they had left, the family had been at the bedside nonstop since admission to the unit. Energetically, this patient was not there. But in this case, there was so much drug and alcohol to lower the vibration, which was weak from being so sick, it did not register.

What surprised me is later the two spirits came to me with a request. They were together. They said, 'we wish there was something different. A third option.'

What I picked up is that 'heroics' was not what they had expected. They were disillusioned. Apparently the choice given them in treatment was 'do you want to die or do everything you can?' They would have preferred, 'do you want us to do a little bit to see if that works and if that doesn't you can make the call and be comfortable.'. 'I didn't want to die like that', one of them said,' it was ugly. It hurt. It sounded harmless when you talked of it.' But now from the new perspective, they can see the impact on the family, both emotionally and financially, and are having their regrets.

'I want to die with honor, faith, and dignity' the other one says.  'Just get my message out. Somebody will understand what I am trying to say. My message is to die like I had lived, on my own terms. When I got so sick, I could not express my wishes just to let me go. I made that choice when I was well. I had NO IDEA how very awful it would get. '

'I would not want hospice. That would say that I am giving up. I want comfort and a shot at it but not all this. I want my family to understand how the heroics are terrible for me, terrible for everyone. I always hear. I always know. I cannot have peace until you stop making a miracle.'

'I want to thank you and everyone for your efforts. That is what you do. That is how you are trained. But the training needs some common sense. Some common sense. To say step back and watch for termination of efforts, be that the dialysis thingy-thing machine that was on my neck and kept clotting up, to the bedsores on my back. They really hurt me and no one treated a thing. Why can't someone like you go up and talk to us about all this? Someone reputable and Light? This is not a death squad for you-live-or-die. Just common sense among the masses that there is something more than 'I sign away my life on this piece of paper for my directive that is advance'. It doesn't mean much of something, anyway.'

'I want the families out there, everyone, to know that reaching out is okay. If you get the feeling of hopelessness, that it may be time for us to go, by all means let us. It has been taking enormous energy from both of us to talk to you right now. And you are trained to LISTEN! Imagine how much more it takes to get through to one of those (shows the grieving family at the bedside). I can grant a hint. That is about it. So when I get that point across, go follow it. I can get one or more family members but that is about it. A HINT. That is for my message for today. Goodbye and good luck with all your studies (on spirit). Namaste.'

Namaste,

Reiki Doc


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