For Love of Unforgotten Times

*Trigger warning-death*

I woke up with the pager screaming on my bedside table. Lifting my head, I glanced at the clock while I reached for it.

“4 am, so close.” I groaned.

Sitting up, I rubbed my eyes, read the number and called back to the answering service. “Hi, this is Mary Murphy, RN on call, what’s the message about?”

“We have a phone call from Lizzy Schmidt, daughter of Sarah Schmidt, your patient.”

I turned on a side light, thumbed through my on-call notebook, quickly finding Sarah’s file. “Thanks, I have the number, I’ll call back right now.”

My husband stirred next to me in the bed. I got up and quietly walked into the bathroom to call Lizzy back on my cell phone.

“Hi, this is Mary Murphy, the nurse, is this Lizzy?”

“Yes, is this the Hospice nurse?”

Her voice sounded so small and young. I quickly shifted my notebook to the bathroom counter to look at the family information; she was only sixteen.

“Yes, Lizzy, what’s going on? How can I help you?”

“My mom said she wants you to come out.” 

 Sarah Schmidt, 38 years old, Stage 4 lung cancer, terminal; basic facts written in her chart. She has been stable as of yesterday per the latest notes.

“Is she having any problems right now? Is she having trouble breathing?” I scanned her medication list as I was talking.

“She has her oxygen on, but she seems a little short of breath.” Lizzy hesitated, then said, “She told me she just wants you to come out right now.”

Looking at the address, I realized it’s not that far from me, maybe a ten-minute drive to get there at the most. “Lizzy, I’m leaving right now, I'll be there in about 10-15 minutes. Have your mom sit upright with her oxygen on. She might need some pillows behind her. Tell her I’m on my way.”

Throwing on my blue cotton trousers, red polo shirt, and black leather shoes, I hurried to get out the door faster. I ran a washcloth over my face, brushed my teeth and combed my short hair. Grabbing my big nursing bag as I approached my bed, I gently touched my husband to wake him.

“Honey, I have to go out on a visit.”

He turned over and rubbed his face, “Almost made it through the night without a call, huh?”

“Ugh, I hate night call, sleeping is almost impossible waiting for the stupid pager to go off. Hopefully, this will be a quick visit.”

Pinning my ID badge on my shirt, I sighed when I looked at my husband. “I’m not sure when I’ll be back, but the kids’ lunches are made in the fridge, and their clothes are all laid out on their dressers. You just have to get them up, feed them breakfast and get them out the door in the morning.”

I felt bad I had to wake him up, but he knows the drill. “Try to go back to sleep, love.” I press a soft kiss on his temple as he touches my hand.

“Drive safe, I’ll see you later, love.”

Finding the Schmidt house was no problem, and it only took ten minutes. I approached the front door, knocked, and a very young-looking girl opened it for me.

 “Are you Lizzy Schmidt?” I asked crisply.

 She pushed her hair off her face, nodded and pointed to the inside of the house. I noticed she was trembling. “My mom is back here.”

The dimly lit living room was cluttered with paper plates, soda cans and wrinkled clothes. I could hear the oxygen concentrator humming in the back of the house. The scent of vanilla from an air freshener partially covered up the stale air. We walked down the hall to a bedroom. Sarah was halfway sitting up in bed, dozing quietly. Her breath slightly labored, but not acutely. She was painfully thin, collar bones and ribs prominent under her threadbare, loose nightgown. A few wispy hairs encircled her head like shadows of garland. Her skin was pale grey, cool and clammy looking. The oxygen tube was in her nose and Lizzy had put a fan on the dresser slowly blowing air around the room. She did have beautiful nails painted red; I guessed the handiwork of Lizzy.

I asked Lizzy how her mothers’ day had been. Did she have a hard time breathing? Was she able to get up out of bed? Lizzy remembered she had been more tired, unable to get up by herself. She didn’t want to eat or drink anything; she just didn’t seem to have any energy, Lizzy thought. Interestingly, she was giving her directions about the house all day.

“She wanted me to get her address book and her jewelry box. Mom told me who everyone was in her address book. She showed me all her favorite jewelry and where and when she had gotten everything.”

Continuing to write my notes, I listened with just one ear. Sarah didn’t seem to be in any acute distress. Maybe this would be a quick visit and I could leave this house and return home before my kids went off to school.

I put my bag down, washed my hands with alcohol cleaner and grabbed my stethoscope, all in hurried, medical mode. “Sarah, I’m the nurse, Mary. I’m here now, what’s going on?”

“Are you the h-hospice nurse?” she asked with a weak voice as she raised her cloudy eyes to look at me.

“Yes, I’m here, what can I help you with?”

“Oh, good, take c-care of my d-daughter.” Sarah took a deep breath, exhaled and closed her eyes.

She slumped over and stopped breathing. I quickly touched her chest and called her name to try to wake her up. I checked her pulse; nothing. I listened to her heart; it had stopped. I froze. She had signed a do-not resuscitate so there was nothing I could do. She was terminal with lung cancer.

Her daughter, Lizzy, was standing behind me. Her eyes grew wide as she started shaking. “What happened? Why isn’t she breathing? Mom! Wake up!”

Lizzy collapsed on the end of the bed and started crying. I grabbed her timidly and encircled my arms around her as we both laid on the bed. I held her as she was racked with sobs. I smoothed my hand down her back as I tried to comfort her. “Your mom died, Lizzy, I’m so sorry.”

I’ve seen my share of people die and been with many grieving family members. Heck, I’ve been a Hospice nurse for almost four years. But this level of need and emotional turmoil was new to me. There’s no map or medical algorithm on how to navigate this situation. I felt profoundly inadequate to offer any nursing advice to Lizzy. Why was I, out of all the hospice staff, put here in this place and time? I thought of my own daughters and what they would need. Holding Lizzy in her anguish, I realized the only thing I could offer her was me, Mary; another human soul placed in this universe and this moment. All I could do was meet her where she was and be a presence; a witness to her deep trauma and hold her. Everything else on my mind quickly dissipated. My physical touch and complete focus on her were the only balm I had right now. 

We stayed on the bed for what seemed like hours and minutes at the same time, Lizzy in shock.

Lizzy finally turned away from the bed with wet, red eyes. She walked out to the living room, flopping down on the couch, rubbing her hands down her face.

“Is there anyone I can call to come over to be with you?”

“My Aunt and Uncle live nearby. My mom had arranged for me to live with them if she couldn’t take care of me. They would want to come over.” Lizzy moved some papers on the coffee table. “I didn’t think it would be so soon.”

I called them and they were shocked that Sarah had died so quickly. They’d be right over they said.

Sitting with Lizzy on the couch, waiting for them, I asked, “Tell me about your mom.”

“It’s been just her and me for as long as I can remember. We did everything together, like we were sisters. My dad’s been gone my whole life. Mom used to say he didn’t like being tied down; he was a tumbleweed.” Lizzy wiped her nose. “She’s the best mom, I mean was, I guess.”

“Lizzy, listen to me. Your mom loved you so much, she called me to come over to be with you. She knew she was going to die very soon. People seem to know when they are going to die. She didn’t want you to be alone. She was watching over you to her last breath.” I held her in my arms again. She was just a child, really.

Lizzy’s aunt and uncle showed up, immediately hugging her and comforting her. I spoke with her uncle and instructed him how to call the funeral home when they were ready to let Sarah go. He agreed and understood what to do.

I held Lizzy one more time before I left. “Lizzy, your mother gave you one last gift, you know? You were always her everything. She took care of you right up to the end.”

Lizzy looked at me through red, swollen eyes, “Thank you, Mary, I’ll never forget you.”

Driving to a coffee shop, I got a Mocha, my one rare splurge. I sipped it while I sat in my car, charting the night’s notes. Out the window, I saw a yellow school bus driving by. The sun was just starting to lighten the road to a soft grey. My kids should be in class by now, first and third grade. Two little girls that look at me like I’m their sunshine. We share our silly baking lessons, I read to them every night even if it’s the same book more times than not. They love to show me all their art projects as I smile wordlessly and clean their mess. I pictured their little faces, just pure joy and love reflected to me. I couldn’t die fast enough if anything happened to them.

I turned my car engine on, I still needed to go back to my office and brief the staff about my night that’s changed me forever. Sarah’s last words came back to me like a whisper.

Yes, Sarah, I did what you asked of me. I won’t ever forget you.