New York Minute

New York Minute

Laura Smith

The clock read 11:50 PM. Ten minutes left in the day. Ten minutes until a new day started. The unit lights were dimmed for rest, sporadically interrupted by the glow of computer monitors at the desk and on the mobile workstations in the hallway. The dayshift chorus of ringing phones, visitors, doctors, gurneys rolling down the hall, and visits from ancillary services replaced by more hushed tones, the rhythmic beeping of heart monitors, the occasional bed alarm when some unsteady patient attempted to make a trip to the bathroom without supervision, and the steady woosh of breathing machines.

Regina rolled her neck from side to side trying to relieve the tension and fatigue that inevitably built up on the third night shift in a row. She had been on nights for the last four years and had gotten used to the 7P to 7A grind; however, the body never truly adjusts to operating counter its natural timetable. She was always exhausted by this point in a three day stretch, but there was a benefit in having her workdays stacked as it let her get to know and become efficient in taking care of the same patient load for consecutive nights. She referred to her floor, more commonly known as the Intensive Care Step Down Unit, as The Tightrope. The moniker seemed to fit as the patient population was not stable enough to be on a regular medical floor, but not sick enough to need an ICU bed. They were all “walking a tightrope” of sorts between the two worlds, and it didn’t seem to take much for a foot to slip and the patient to need a more acute level of care. While this made for some exciting work stories, the constant need for enhanced vigilance from nursing meant that the brain could get worn out quickly. Tonight was a calm night; an adjective Regina was loathe to use because speaking the “c” word was met with the superstition that all Hell would inevitably break loose upon its utterance. These nights were rare, where a nurse could take a breath and even enjoy a lunch break. Regina held onto these nights with both hands and knew to appreciate them for their scared scarcity.

As the clock churned closer to midnight, Regina got up to make her hourly rounds on her patients. There was room 350 who was two days post open heart surgery and finally sleeping like a log after finding the perfect mix of pillows and head elevation to make the chest tubes less irritating. Room 352 who became more confused as the sun sank lower in the sky, and spent all night very much convinced she was in her kitchen, not a hospital room. Thankfully, she did not try to get out of the bed and was easily distracted by folding the mountain of hand towels Regina provided as an activity. Room 354 who had a nasty pneumonia, requiring high levels of oxygen and enough IV antibiotics to burn the veins of 1,000 men, but was considered stable, for the moment. Finally, Regina peaked her head into room 256.

“Hey, Tony. Can’t sleep?” Regina asked, noting that her patient was sitting up in bed, staring at the wall without the TV or any lights on. Tony was here with the other dreaded “c” word. Cancer. It had been found six months prior and had spread with a speed that baffled even the doctors. It cannibalized his red blood cells faster than they could be replaced both naturally and with repeated transfusions, which lead to severe shortness of breath, fainting and blood pressure which would bottom out without warning. To look at him, you would never imagine he was terminally ill. Sure, his skin was pale, but his lanky six foot frame did not give any other outward hints of sickness.

“I am going home tomorrow,” Tony said, looking up at the clock. “Well, I guess it is today now.”

“I heard that was the plan,” Regina replied as she observed the IV bags hanging by the bed, the IV pump settings, and the last round of vitals showing on the monitor.

“I won’t be coming back to the hospital,” Tony stated. Simply. Quietly. Even in the dark, Regina could see his eyes shimmering with unshed tears.

Regina stopped her assessments and regarded the man in front of her. She had been Tony’s nurse the last three nights, as well as once or twice before on previous admissions in the last few months. He was the model patient. Polite, respectful despite the pain and discomfort he was experiencing. When she saw his name on her patient assignments, it was always met with a sigh of relief. Not a very talkative individual, but he exuded a kindness and peace Regina wasn’t sure she would be able to muster if faced with the same diagnosis.

“What is on your mind, Tony?”

“The last six months, it has all been focused on ‘What is the next step? What treatment is next?’ And now, the only ‘next step’ is an incredibly final one, and I don’t know, it is all just kind of hitting me that when I leave this room tomorrow, I leave to go home for the last time. I guess I am a little scared.”

His statement hung in the air for a few seconds. Heavy as if the words held a weight that was tangible. Regina had seen more than her fair share of death. She had been present at many end-of-life situations, both planned and emergent. She wouldn’t say she was used to it, but there was a professional detachment that had been cultivated. This felt different. This wasn’t clinical in terms of medicines, labs, tests, and heroic measures. This was a man, a man she honestly barely knew, facing a huge and very scary unknown and admitting it to a person he barely knew, but trusted with the admission. Regina was suddenly even more grateful for the calm pace of the evening as she turned from the IV pump to her patient.

“Tony, would you like to talk about it? With me?”

Tony shifted uncomfortably in his bed and replied, “Nah, I know you are busy. I can sort it out myself.” His words held one message, but everything about him was screaming for someone to listen. Regina smiled, put a hand on his shoulder and said, “Give me five minutes to handle a few things and I will be back.”

She stepped out of the room, shot a text to her charge nurse to tell her she would be in room 256 if needed, grabbed a chair from the nurses’ station, and positioned it near the end of Tony’s bed so they could chat without feeling like she was invading his personal space.

“You don’t have to do this. I am sure you have more pressing things on your plate than my issues,” Tony offered, looking down at the sheets.

“Well, as luck would have it, you picked an incredibly slow night to need a friend to talk to. “Now, if the world collapses around us and all the alarms start going off, I am holding you personally responsible,” Regina replied with a smile, which got a small answering smile from Tony.

“I don’t even know where to start…this just feels so…massive.”

“Well, we don’t have to tackle everything at once. How about this, help me get to know you a bit better. Given your accent, I know you aren’t native to the South. So where are you from?”

Tony appeared relieved by the banality of the question and visibly relaxed. Regina was not surprised to learn he was originally from the Bronx and was a huge Yankee fan. She was surprised to learn that her kind, quiet patient had spent his entire career with the NYPD and had retired five years prior from his role as a homicide detective. He had relocated to the South to retire and trade the hectic rush of the city for a two bedroom, two bath on a lake in golfcart community. Tony joked with Regina that the only downside to the move was the inability to find decent pizza or bagels anywhere. Regina joked back that he should have given up his Yankee fandom for the Braves after he crossed the Mason Dixon Line. The two fell into an easy banter, sharing stories of growing up, vacations, and family gatherings.

At the hour mark, Regina stood up and said, “Hold that thought for a minute, Tony. I need to do a quick check on my other folks and then, I will be back.” True to her word, she returned ten minutes later, and the conversation resumed with Tony telling a simultaneously hilarious and embarrassing story about an ill-fated attempt to learn how to sail a boat in Florida on his honeymoon seven years ago with his second wife, Cassie. At the end of the story, Tony stared at the wall. Regina could sense he wasn’t seeing anything in the room at that point, and that this was the type of silence that represented reflection and did not need to be interrupted by conversation.

After a few minutes, Tony looked at Regina and said, “I feel like I am letting Cassie down. In such a major way. I promised her a lifetime of memories seven years ago and her I am, bailing on my promise. I am worried sick about leaving her.” With that a sob escaped his throat and he buried his face in his hands. Regina watched as the sobs wracked his shoulders. She waited until Tony was able to regain some composure, reached out, and grabbed his hand. “Tell me about Cassie.”

Tony sighed and looked at the ceiling. “She is everything to me and nothing I deserve. She has been my steady place but isn’t afraid to call me on my shit. She is an angel, and I don’t know why she puts up with a stubborn man like me. I have never had kids, and I don’t regret that, but I do regret the fact that I am leaving her alone, without me.”

Regina countered his statement with a question, “If you knew that this was how your story ended, would you have fallen in love with Cassie all those years ago?”

“Yeah,” Tony replied. “I don’t think I would have been capable of walking away from her.”

Regina asked, “And do you have any regrets about your time together? Other than where we are right now? Have you been the best person you could be towards her?” Tony considered this and said, “I have zero regrets about our marriage. We have made some amazing memories. And I haven’t been perfect, but I have tried to show her how much I love her. How important she is to me.”

“Then, I think you held up your end of the bargain, Tony. And I would be willing to bed if I were to ask Cassie if she would have still married you seven years ago, with the knowledge of this outcome, I am sure her answer would be an emphatic ‘Yes’. I have seen a lot of death. As have you in your career. Have you ever seen someone regret a loving relationship? Mourn and grieve its loss, sure, but ever REGRET it or wish it hadn’t existed?”

“No. I haven’t,” came the quiet reply.

“Then, I think that is one source of guilt you can remove from your plate, friend. Okay, it is 2AM, I need to go check on my other people and grab a cup of coffee. You want one?”

“Man, that sounds good. I miss coffee, but my cardiologist said I need to stay away from it.”

“Why? Because it might mess with your heart or kill you?” Regina asked. Her comment infused with good natured sarcasm. Tony halted for a second by her bluntness and then started belly laughing. Tears forming in his eyes for an entirely different and welcome reason. “Well, when you put it like that…Yes, this soon to be hospice patient would LOVE a cup of the finest hospital coffee you have!”

As Regina brewed a fresh pot in the breakroom of the fancy French Roast she kept in her locker, not the hospital provided swill, she found herself running her thumb over the spot where her wedding band used to be. A casualty of long hours and a union entered too young and hastily. Cassie and Tony were lucky. Not with the outcome, but for the years spent together making the most of life. Regina also felt honored that Tony was trusting her enough to be vulnerable. Making these kinds of connections with patients was the best part of the job and made the unpleasantries far more tolerable. She returned to 256 with two steaming cups of coffee to find Tony holding his phone with photos pulled up to share of Cassie, his dogs, and random adventures.

The conversation drifted from the serious to the playful. Best concerts. Worst trips. Favorite pets. Best jobs. Interesting vacations. Each trading a little piece of their lives and experiences for an insight into the other’s. Upon finding out that Regina had never been to New York City, Tony made Regina promise she would travel there within the next year and gave her a detailed list of things to see and food to try. Every hour they would break for Regina to go check on her patients, but the exchange would pick up like she never left. Soon it was 6AM. They both knew shift change was approaching, and this night of conversation would come to a permanent end.

Tony fiddled with his now empty second cup of coffee. He looked at Regina and asked, “What do you think it is going to be like?”

“Dying?”

Tony nodded, unable to form more words on the topic.

Regina sat back and thoughtfully considered his question. After a long pause she answered, “I think you are going to be at home, surrounded by love, without pain. That you are going to drift off to sleep with Cassie holding your hand and that it will be a dignified, peaceful end to a remarkable life.”

Tony let the tear escape down his cheek. “I hope you’re right. All these memories, all these moments. They have taken my whole life to make, and now, it seems like time has passed in the blink of an eye. So fast. Like a…”

“Like a New York minute?” Regina offered, taking a slow sip of her coffee.

“Exactly. Like a New York minute. That is perfect.” Tony replied, a sad smile tugging at the corners of his mouth.

“Tony, I want to thank you for allowing me to be a small part of your story. For sharing with me and letting me share with you. I can say that this has been one of the most meaningful nights of my nursing career, possibly my life. I am honored that you let me be part of this journey with you.” With that said, Regina stood up and bent over the bed to hug Tony. He returned the hug with warmth, a smile and said, “I need to thank you. When the night started, I was scared. Talking with you has both calmed me and given me a wonderful distraction, even if it is just for a little while. I can’t put into words how much I appreciate you sitting with me and the universe allowing a quiet night for it to be able to happen. You have no idea how much I needed this. Promise me you’re going to keep living life to the fullest and making memories every chance you get.”

Regina squeezed Tony’s hand and exited the room for the last time. She clocked out and made the drive home in silence. She had taken down his full name and birthdate. A HIPAA violation, but not one anyone would ever find out about. Two weeks later, Regina started typing in his name and the word “obituary” every day. Nothing popped up until the third week. There it was in black and white. Tony was gone. He had passed away peacefully at home with family by his side.

Seven months later, Regina found herself in New York following Tony’s itinerary. She had been to the Zoo, the main tourist traps, an amazing pizzeria, and a couple of dive bars. Now, Regina found herself with a fresh cup of coffee, standing on the bridge in Starlight Park in the Bronx. This was the bridge where Tony had proposed to Cassie. She took a quiet moment to remember the patient who had entered her life so unassumingly but left such a profound mark. She looked at the New York skyline stretching out to the south of the bridge, pulsing with the energy of a living thing. She took a sip of the coffee, held it up and said, “I am keeping that promise, Tony.”