Summer Time
The charge nurse looked at the computer screen and continued, “Summer, this is your first patient. His name is David Stover, 23 years old, was driving on interstate 78, cut off by a tractor trailer, crashed and sustained a traumatic brain injury, severe intracranial hemorrhage, broken pelvis, multiple cervical fractures, flatlined on the way to the hospital revived with defibrillator, minimal brain function, placed on hospice care on Wednesday. He doesn’t seem to have any family or friends.”
“Where are his parents?” I asked.
“He doesn’t have any, “she replied. “Mom gave him up at birth, raised in a series of foster homes. He aged out of the system at 18. We don't know where he has been living since. The address on his driver’s license turned out to be a mail drop.”
“Has anyone visited?”
“Two of his coworkers from the auto repair shop where he worked came in once, but they didn’t know where he lived either.”
“I guess we’re his family now, “I said wistfully.
I came closer to David and studied his face. It was my first day on the job at the hospice ward of Dayton General Hospital. He seemed to have a serene expression on his face, blue eyes sunken in, deeps lines creased across his forehead, and there was an apparent scar across the left cheek of his face. There was plenty of evidence of hard living and he looked much older than his 23 years. Yet there was a certain softness around his eyes and lips which were slightly curled up in a half smile. He had sort of a benign look, like he was a kind man who probably suffered a lot having been knocked down by life.
My job as a hospice nurse was to provide end of life care by making my patients as comfortable as possible. What most people don’t know is that the body knows what to do when the time comes. You feel less pain, lose the desire for food and drink, and spend more time sleeping. At the very end, there is the death rattle when breathing gets very labored and finally the pupils roll up in the eyes as the optic muscle grows slack. David wasn’t quite there yet, and I was determined to make his last few days as good as I can.
The next week I saw the signs that David was near the end of this journey called life. We had stopped using the feeding tube and were now only giving him IV fluids. There were only hours left, maybe minutes. I normally like to stay with the patients during these last moments, calling in the doctor to make the final pronouncement, filling in the preliminary paperwork, calling for the gurney to make the final trip to the morgue. This time, however, I had to leave the hospital to make some home visits. I informed the charge nurse to text me if there were any further signs that death was immanent, and I would come back as fast as I could. That text came in two hours later which said, “BP dropping fast, shallow breathing.”. Luckily, I was only 10 minutes away and made it on time. I could see the life draining from his face, which brightened for the first time. He briefly opened his eyes and stared at me; his gaze fixed on my face. A raspy voice said, "Summer, I’m so sorry they popped your balloon. You can have mine. Don’t cry Summer.” Then his eyes closed, and he breathed his last breath.
“You know, David spoke to me just before he died, “I told the charge nurse when we were alone together. “He knew my name.” “That’s not so surprising,” she replied. “Patients who appear to be in a coma can sometimes still hear things. He must have heard someone call your name.” “Ok, I understand that” I replied. “But he said something that referred to something that happened to me in childhood, and I never mentioned it here, so how could he have known?’ “Are you sure it couldn’t be a coincidence?” she asked. “No. It was something very specific. Did David ever go by another name when he was a kid?” I asked. She clicked through the electronic medical records for a few moments. “Yes,” she said. “When he was with his first foster home, he went by the name David Rowan.” That name was very familiar and then it hit me. David Rowan was a classmate of mine in the fourth grade! When my balloon was popped by a mean classmate at a school party, I started to cry. I had spent all day decorating that balloon with magic markers. David saw what happened from across the room and immediately walked over and gave me his. It seems like a little thing now, but it made a big impact on a nine-year-old girl. It all made sense now. Terminal lucidity is the medical term for a momentary recollection of a memory just before dying. David’s last memory was an act of kindness he did for me so many years ago. The well-known phenomenon of the flashback just before dying is technically known as the life review. Did he recognize me and that triggered the memory of so long ago? Did my distinctive name stick in his mind? That incident must have been as important to him as it was to me. I just knew he was a kind man. I only wish I knew him better.
“Where are his parents?” I asked.
“He doesn’t have any, “she replied. “Mom gave him up at birth, raised in a series of foster homes. He aged out of the system at 18. We don't know where he has been living since. The address on his driver’s license turned out to be a mail drop.”
“Has anyone visited?”
“Two of his coworkers from the auto repair shop where he worked came in once, but they didn’t know where he lived either.”
“I guess we’re his family now, “I said wistfully.
I came closer to David and studied his face. It was my first day on the job at the hospice ward of Dayton General Hospital. He seemed to have a serene expression on his face, blue eyes sunken in, deeps lines creased across his forehead, and there was an apparent scar across the left cheek of his face. There was plenty of evidence of hard living and he looked much older than his 23 years. Yet there was a certain softness around his eyes and lips which were slightly curled up in a half smile. He had sort of a benign look, like he was a kind man who probably suffered a lot having been knocked down by life.
My job as a hospice nurse was to provide end of life care by making my patients as comfortable as possible. What most people don’t know is that the body knows what to do when the time comes. You feel less pain, lose the desire for food and drink, and spend more time sleeping. At the very end, there is the death rattle when breathing gets very labored and finally the pupils roll up in the eyes as the optic muscle grows slack. David wasn’t quite there yet, and I was determined to make his last few days as good as I can.
The next week I saw the signs that David was near the end of this journey called life. We had stopped using the feeding tube and were now only giving him IV fluids. There were only hours left, maybe minutes. I normally like to stay with the patients during these last moments, calling in the doctor to make the final pronouncement, filling in the preliminary paperwork, calling for the gurney to make the final trip to the morgue. This time, however, I had to leave the hospital to make some home visits. I informed the charge nurse to text me if there were any further signs that death was immanent, and I would come back as fast as I could. That text came in two hours later which said, “BP dropping fast, shallow breathing.”. Luckily, I was only 10 minutes away and made it on time. I could see the life draining from his face, which brightened for the first time. He briefly opened his eyes and stared at me; his gaze fixed on my face. A raspy voice said, "Summer, I’m so sorry they popped your balloon. You can have mine. Don’t cry Summer.” Then his eyes closed, and he breathed his last breath.
“You know, David spoke to me just before he died, “I told the charge nurse when we were alone together. “He knew my name.” “That’s not so surprising,” she replied. “Patients who appear to be in a coma can sometimes still hear things. He must have heard someone call your name.” “Ok, I understand that” I replied. “But he said something that referred to something that happened to me in childhood, and I never mentioned it here, so how could he have known?’ “Are you sure it couldn’t be a coincidence?” she asked. “No. It was something very specific. Did David ever go by another name when he was a kid?” I asked. She clicked through the electronic medical records for a few moments. “Yes,” she said. “When he was with his first foster home, he went by the name David Rowan.” That name was very familiar and then it hit me. David Rowan was a classmate of mine in the fourth grade! When my balloon was popped by a mean classmate at a school party, I started to cry. I had spent all day decorating that balloon with magic markers. David saw what happened from across the room and immediately walked over and gave me his. It seems like a little thing now, but it made a big impact on a nine-year-old girl. It all made sense now. Terminal lucidity is the medical term for a momentary recollection of a memory just before dying. David’s last memory was an act of kindness he did for me so many years ago. The well-known phenomenon of the flashback just before dying is technically known as the life review. Did he recognize me and that triggered the memory of so long ago? Did my distinctive name stick in his mind? That incident must have been as important to him as it was to me. I just knew he was a kind man. I only wish I knew him better.
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