De Paul University
Writing from the Inside
Teacher: Zoe Keithley
Eleanor’s Point of View
Eleanor is 86 years old. She is a ward of the state and has lived in an institution for 42 years. She is in the hospital now because of dehydration, pneumonia, and a generalized infection.
She is not aware of her surroundings. Her body is contracted into a fetal position; a position that was once safe for us all. She cannot do anything for herself, not even feed, clothe or toilet herself.
Eleanor is in the intensive care unit so that her vital signs can be monitored continuously. She is not doing well; her blood pressure is so low that drugs are now being used to force her to have a blood pressure; she is receiving blood because of a bleeding ulcer.
The code blue alarm go off; Eleanor’s heart has stopped beating. I ran in to answer the code. Her face is blue – she is breathless. The monitor is without the blip that gives evidence of life. Many nurses, doctors, and supervisors enter the room to answer the code as well; they are out of breath.
They force air into her lungs by way of a long tube they just inserted into her trachea. They pound on her chest despite the fact that its deformed; she can’t even lie on her back. Her knees are bent up to her nipples, and her hands are permanently bent up to her upper arms.
Next to her ear, I whisper, “Go ahead and go – find your final peace. It’s OK to die, we have that right”. Her eyes have tears dangling from them. There is vomit floating around the tube in her throat. Tiny whitish blue deformed fingers twist inward into her palms. Her face is wrinkled, and her hair is matted down with sweat. I can see the shape of her rib cage, laying just beneath her blue skin. As the air is forced in, I see her chest rise, but have a sense of intrusion – we are intruding into her rightful death.
In the hall, there is the sound of the public address system calling other doctors. There’s an announcement about the next CPR class to be held for staff nurses. The printer is delivering the latest lab reports. The transporter voices his anger that Mrs. Fryer is not ready to go down for an x-ray; these nurses are so inefficient.
Eleanor wonders as she looks down from her ceiling viewpoint (able to think again for the first time in 40 years), “I thought nurses and doctors were smart? I thought they knew when someone died; weren’t they trained in that stuff? How could they think they are doing something for ME? What is it they are trying to save me for? I’ve suffered so long. Can’t they see I’m dead”?
Don’t they know that she is already up here with Me in heaven? Why do they feel obligated to fight for this lost soul? What do they think they are gaining for her? Will they gain simply in usurping Me? Twisted helping. What have I done in creating mankind; did I forget to tell them that death is natural and inevitable? Where did I go wrong and what can I do to fix it? “Get the board under her – did she get Epi or atropine? What’s her diagnosis”? says the house physician. “Oh shit, she’s in V-Fib, shock her quick. We’ve got a pattern now, it’s functional. Does she have a pulse? Do we have a pulse and blood pressure? Who’s attending? I think we’ve done it. Get a vent up here. Get some gases”.
We are obligated to save lives; we were trained in medical school to use all the latest technology. I didn’t spend all these years in medical school and residency to let people die. Who the hell is this nurse telling the patient that she can die; who the hell does she think she is? We are not here to judge when and how much technology to use. We are here to save lives – that’s it. You use all that is available; if you don’t, they sue you.
Nurse Rhonda, with tears running down her face, steps back in disbelief; didn’t they hear me when I told them about this patient? I did say that this woman was already a “veg”, didn’t I? Why are they doing these dumb heroics? This is the worst night I have had in a long time. I want her to die; I want her to be allowed to die. I don’t want to see her on a ventilator. I feel as though instead of comforting and helping people I am torturing people; they have no rights.
I’m the supervisor, I’m supposed to see that things are done by the book and that everyone follows policy. I don’t want them to follow proper ACLS (advanced cardiac life support) procedures and make this poor person die restrained, drugged, and on a respirator. How can I pretend to enforce what I don’t believe in? How dare she (an AGENCY nurse) tell the patient that she could die? How can she have the gall to say what she really thinks? I wish I could give the lady permission to die. But I can’t. I must maintain the image, the status quo – the way it’s always been.
I hate this, I wish I had not heard the code alarm; I wish I had never come into this room. I could have avoided it, being a lowly agency nurse who doesn’t know anything. I can feel their disapproval of me; they think I must be nuts to tell a patient to go ahead and die. This is so stupid; I can’t stand this anymore. Must we continue to put every 90-year-old on a respirator when they try to die? Is it mandatory to use every ounce of technology all the time? Can we let this ultimate intrusion of privacy remain legal?