Last week, just before I started my shift, a patient died. He had first entered the hospital with heart trouble, suffered complications and was placed on a ventilator. He came to us in fairly good shape relative to some of the other patients we get. There is this semi-conscious state that a lot of people linger in as they start to wake-up from the complications they suffered through (some for weeks on end) and were completely unaware of. They are "in there"; they try to respond to your commands, though often they fail due to sheer physical inability. And they try to communicate - their lips are moving and their expression changes, hands gesture. It is almost impossible to make out what they are trying to say because they are unable to vocalize on the vent and frequently lack fine motor control, so you can't read their lips (something I've actually become pretty adept at over the last several months). And, of course, they are generally confused and would be speaking nonsense and non sequiturs could they actually form words. As I said, people can linger in this in-between state - aware but not oriented, trying to communicate but not coherent enough to realize what they need to do to overcome the barriers. Some stay like this for only a few days, others for a few weeks and a few never find their way out. They remain locked in their own mind for reasons that are rarely clear. He was one of the latter, though I must confess I thought the family moved rather quickly to putting him on a terminal wean. I think they were talked into it by their doctor(s) and though it is fairly likely he would have never pulled out of this half-life, I wish they had given him a another couple of weeks. Miracles do happen.
I ended up helping the family - his wife and daughter - carry some things out to their car. It was a somber walk and one that left me reeling. What do I say? How do I offer comfort? In the end, I didn't say much. I told them I was sorry for their loss and that I had enjoyed caring for him. But in my mind, as I'm walking with those suffering the agony of their loss and the mixed feelings of guilt and relief, the hymn from Sunday's liturgy repeated itself over and over in my head. "Christ is risen from the dead, trampling down death by death..." And that, to me, provided some comfort, some degree of understanding. His death was not the end. Death is not the end and the pain is just for a night.