Guest Post by Jim Jackson
In the fall of 2008, at our monthly Kaiser hospice volunteer in-service training meeting, we discussed the following talk given by Dr. Jessica L. Israel. For me, personally, it was a smaller spiritual wake-up call preceding the major spiritual wake-up call two months later when my wife, Molly, suddenly passed-on, with no warning or cause ever found. “It was a very big deal!“
At the end, I will ask a question, one I ask myself several times a day.
“Have I missed the moment – the ‘WOW’? Or did I remember to BLESS it?”
It’s Monday morning, and I meet my new medical student, Nielson, on the hospice unit. I am there to sign a death certificate for a man who died the night before. Nielson is flipping through the patient’s chart, and he asked me, “ What are we going to do for this patient today?”I wonder if he’s kidding, and I say: “Nothing. He’s dead.” Later, recalling this conversation, I still cannot believe I said it so matter-of-factly.
Nielson is still holding the chart and I think I see his hands shake.
“Hey, are you OK?” I ask. You do know what you signed up for, don’t you? It is a palliative-care and hospice elective. People are going to die every day.”
“I know, I know,” he says. “I’ve just never been near anyone who has died before.” Then he says, “WOW, it’s really a big deal.” And he sits down — because he needs to, I think; he needs to respect the MOMENT.
In this moment I learned something from Nielson, a lesson I thought I already knew. I learn to slow down, to feel the gravity of the moment, the power of time, and the depth of this important work . Nielson is right. It is a big deal.
Nelson’s “wow” makes me think back to my first death. I was a third year medical student at Mount Sinai. It was a big day for me because my resident was going to let me do a paracentesis.
Patients with advanced liver disease can have something called ascites – too much fluid in the abdominal cavity, which can be uncomfortable, and can make it hard to breathe. A paracentesis is a way to remove that extra fluid. You place a needle, and then a catheter, through the skin and muscle under the navel. Then you let it drain into bottles lined up on the floor.
As I was about to start, my patient became unconscious. Someone called a code, and what seemed like a million doctors and nurses ran into the room. They did CPR, pushed meds, used the paddles. I had my sterile gloves on, but I was pushed to one side. I heard my patients ribs crack under the weight of the compressions. I watched residents bag his mouth until the anesthesiologist intubated him and hooked up the ventilator. Electrocardiogram strips littered the bedside; an intern tried to place a central line in his groin. After 20 minutes, the lead resident said: ”That’s it. Thank you all very much. Time of death 3:15.”
Everyone left just as quickly as they had arrived, and for a moment, MY MOMENT, I was alone with this dead man. Me with my sterile gloves, and him— naked with his mouth open. My eyes filled with tears, and I hoped nobody noticed. I had been so preoccupied by the opportunity to stick a needle into a belly, that I overlooked the seriousness of his disease.
I covered him with a sheet crumpled at the foot of his bed. I learned that day that I needed to slow myself down, to appreciate the gravity of the moment, the power of time, and the depth and proximity of my work. IT WAS A VERY BIG DEAL!
Nielson comes and goes, and I have a new student. Again, I am rushing to get everything done. This time I am on the hospice unit and I go in to see a patient I haven’t seen since before the weekend. She is sleeping, and her hair is brushed back from her face. I introduced myself to her son. He tells me he thinks she is comfortable, but had a rough night. I decide not to wake her, because I figure rest is more important than agitating her out of her sleep. I am on my way off the unit when her son calls after me: “Can you come back? My mom wants to tell you something.”
I am back at the bedside. This time her eyes are open. I touch her cool hands. “Do you want to tell me something?”
She holds my hand to her face and pulls me close. “I wanted to thank you for this. Thank you.”
There it is again — ANOTHER MOMENT, ANOTHER NEAR MISS. I was rushing to get the day started. I would not have awakened her. I would have just moved on to the next thing I had to do. I would’ve missed the chance to feel the “WOW.” It is a very big deal. How quickly we forget, and how lucky we are to be reminded, before it’s too late .
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HAVE YOU MISSED THE MOMENT—THE WOW? OR HAVE YOU BLESSED IT?
Every day, I experience a wow moment. Most are very subtle – as when I recognize someone being helpful, kind, and compassionate — taking a step forward, spiritually. That’s a very big deal!
As I get older and less able, what keeps me going is the love and the “wow moments” with my family and friends.
“We do not remember days, we remember moments.” Cesare Panese
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Jim Jackson enjoys reading, writing, and sharing his experiences with those in his community and friends. He still has an interest in tennis, he says.
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