C/W: terminal illness
I found him lying on the sidewalk with a bloody smear streaked across his gray forehead. Black rim glasses lay nearby broken in two. Like me, he’d just left the gym on that mid-June day when the cloudless sky and fresh air made me glad to be alive. But the man hadn’t even made it to the parking lot. It had to be a heart attack, I thought, clogged arteries, dying muscle.
The last ashen face I saw was my sister Conni’s on the day she died. Her belly had been swelling for months. It was Hep C the doctors said, from a blood transfusion. Before they knew better.
A guy in a gray shirt with the gym’s logo on the pocket knelt beside the man, said the guy was okay, just waiting for the EMTs. But the man was motionless, not breathing. Leaning close to his ear, hand on his shoulder, I shouted, “Hey buddy, take a breath.” There was no facial grimace, no movement. In under five minutes his brain cells would die.
Conni had six weeks from diagnosis to the end. Less time than most victims of liver cancer, but eons beyond this man.
“Someone call 911!”
“Yes, yes, they have been called,”said the man kneeling across from me.
In a matter of days my sister's heart became progressively weaker. her strength dwindled along with her ability to swallow and stay awake. I’d painted her toenails bubblegum pink when she could still get up. Toward the end, her feet became cool and blotchy, swollen like grotesque little sausages.
I moved my index and middle fingers along the man’s neck. Pediatrics was my nursing specialty. I’d never before felt a person's neck without a pulse. I knew what I had to do, but hesitated to begin, and rechecked.
Conni’s bloated figure rested on the Hospice bed upstairs in the front bedroom. That day, my sister missed out on the sunshine and shadows flickering around the room. Sugar maple branches waved outside her window. Bright orange and red against a brilliant blue sky, the leaves were just beginning to let go, pushed against the glass by the wind.
I lifted the man’s shirt.
“I’m scared,” Conni said from where she lay with hands folded over her body.
“What are you scared of?”
She lifted her gaze to mine, imploring, “I don’t know what it will be like. What if it’s horrible, worse than this?”
“Oh, no,” I said, “It’s going to be wonderful. You’ll be free. Floating above everything. You’ll be weightless, like in a flying dream, you’ll be in the breeze.”
“Do you really think so?”
“Oh, yes. Absolutely. It’s going to be wonderful.”
She closed her eyes after that. Her face relaxed a little.
Sudden cardiac arrest gives no time to be afraid. Instant nothingness, like a cord pulled from an electrical outlet, life ends without a flicker of fear. The man’s soft skin was still warm under my finger as I traced his lowest rib to the breastbone. I laid the heel of my right hand over his sternum, left hand over the right, fingers interlocking. I pushed straight down.
No one does chest compressions on the terminally ill. Resuscitation on my sister’s chest, unimaginable, painful, prolonging the agony in the cruelest way.
After dabbing her face with a cool cloth, I swabbed her dry cracked lips with a spongy lemon-flavored Toothette.
His rib cage and breast bone felt compliant, easily depressed two inches. “Get the AED,” I shouted to the flummoxed observer kneeling across from me. An electric shock to the heart can be the key to surviving a heart attack as the signals are reorganized, synchronizing the muscle fibers.
She was my older sister, but I was taller. Only eighteen months between us, Irish twins. Long ago, on a warm summer evening, Conni and I walked along a country road and came upon a horse pasture surrounded by wire. I intended to step up on the fence in hopes of coaxing the chestnut mare closer. I grabbed a hold, screamed and spun around in circles with the electric shock that vibrated up and down my arm.
A defibrillator jolt is like being kicked in the chest by a mule.
The automated external defibrillator pads in place, a monotone robotic voice said, Analyzing data. Do not touch the victim. The man lay flat on his back, both feet splayed out. The machine searched for a rhythm while I knelt at his side, waiting. Shock advised. Do not touch the victim.
Aware of the powerful shock about to be delivered, my breath held, I hit the red button. The man’s body jerked. Suddenly he drew in an enormous breath like a drowning victim gasping at the water’s surface. Perhaps I’d been wrong and he wasn’t dead after all. His face color improved for about three seconds but went gray again. My hands back on his chest, I resumed compressions.
Dying gasps are known as agonal breaths, a sign that the body is not receiving the oxygen it needs. Terminally ill patients near death might take occasional breaths for many minutes before the final one. Conni’s agonal breathing lasted nearly an hour. Her breath stopped before the heart, just a beat now and then. Conni’s time had come. The family entered the room for a final goodbye.
A siren screamed in the distance and wound down at the curb next to us. Black clad EMTs appeared with a tool box of supplies.
Splitting away from the man at that moment felt strange. I wanted to stay with him, not ready to let go.
After Conni’s last heartbeat, when we were alone once more, I lay down next to her, holding her and kissing her face until her skin lost elasticity and her body turned cold. They told me I had to let go. The mortician assistants moved her body onto the stretcher. They covered my sister’s face with a sheet.
I walked over that sacred place on the sidewalk three days later. He was a complete stranger but was all I thought about. My hand went to the door and as I pulled hard, I looked up to the deep blue sky.
Just then, a warm breath of wind reached my face and blew the hair from my eyes.
At the check-in desk, the manager handed me a red envelope with a dime store greeting card inside. The man had written in shaky script, thank you for saving my life. On the front, an angel in pink with shimmering wings hovered over the Earth. Below was an inscription written in swirling letters, Angels are real.