Growing Up with the Grim Reaper
Growing up, we used to refer to my mom jokingly as the “grim reaper”. She worked as a hospice nurse and conversations about death and dying were commonplace in our house. She would come home saying “I switched this man over to hospice yesterday and he died today,” like it was a great thing. She went to a funeral a week. She had this miraculous ability to hold someone’s hand and tell them it was ok, and off they’d go to the other side. A recent example- my uncle’s father had been dying slowly of pulmonary fibrosis for years; rapidly declining for months; and actively dying for weeks. She walked in the door and he breathed his last breath.
To those who don’t know better, this sounds awful! What is she doing to these people? Is she a bad nurse?
As a kid, I often had trouble understanding how death or the ability to transition someone peacefully to death could possibly be a positive thing. I knew that these people were dying anyways, and that no matter what she (or anyone) did, that was the inevitable conclusion. I knew that having someone who is comfortable with death and dying helps make that passage easier. But I didn’t understand why she would want to do this, let alone how she does it. She’d tell us about her day at work, we’d say something like “the grim reaper strikes again” and chuckle. It wasn’t until I became the grim reaper myself that I realized what that entails.
I am not in hospice or palliative care- in fact, I work on the opposite end of the spectrum, in the cardiac ICU, where we fight death with extraordinary measures all day every day. I think in this setting, it is easy to lose sight of the big picture- to stop looking at the person and focus on the diagnosis. “The STEMI in RM 32”, “The VT arrest in 25.” From an emotional stand point, it is MUCH easier to think of it that way. Depersonalize it. But it is not a diagnosis sitting in that bed, it is not a patient… it is a human being- somebody’s mom or dad or spouse or child.
When you look at it that way, it is much harder to avoid seeing the pain and suffering. We push to extend life, often regardless of quality. We put people through central lines and chest tubes and surgery after surgery, start pressors, start dialysis- and I think often we fail to consider what that is like for them. It is hard to watch people laying in bed for months at a time, not able to eat or drink, or even communicate. Can you imagine being thirsty for 3 months? Or to have an itch you can’t move to scratch?
It is hard for me to understand how it is worth it. I have seen some improve, even some miraculous recoveries- but I have also seen too many of these people fight for months, survive, make a miraculous recovery, only to bounce back to the hospital and die of something else only weeks later. In those situations, I can see how having the grim reaper visit early might be better.