"I don't just read Pulse, I adore it." --Donald Berwick MD
It was a Wednesday in late spring, 1972. I was a nursing student in my final months of training, eagerly awaiting graduation.
When I arrived on the maternity ward that morning, my nursing instructor told me that I'd be caring for a baby, only hours old, with special needs.
I thought she'd send me to the neonatal ICU. Instead, to my surprise, she motioned toward the linen closet, its doors closed tight.
"The baby was born without a complete brain," she said. "A condition called anencephaly. He can't see or hear. And," she added, "they don't expect he'll live out the day. So try not to get attached."
Albert Howard Carter III
(for NCC and RAC)
My wife lies in the little room,
tight as a drum, and even more convex.
She breathes hard as the contractions come.
The doctor, some 20 feet away,
shares his lunch with me,
the husband and coach;
My wife, lunchless today,
hears this act of betrayal
and resents (I learn later)
that we are eating cake:
she's clearly in "transition,"
when even the nicest women
can become cranky.
Groans and wails fill the hall;
The place sounds like a zoo.
Jeez mate, you are really dead. "Really fucking dead," as you would say. I don't need to be a doctor to know that. The cop who rang me was right. You must have been sitting in your lounge chair, dead, for at least twelve hours, maybe more. Looks like you were enjoying a quiet drink when you checked out.
I’ve got to tell you mate, it's pretty weird sitting here at your dining table, with you there, slumped over all mottled and cold, while I'm trying to fill out your death certificate. With your advance-care directive staring at me from on top of all your papers on the table. Was it left there as a gift for me? I did feel a little better when I read that you wanted to be allowed to die a natural death. That you didn't want any more medical interventions (God knows, you'd had enough of those already). That you wanted to die in your home.
Was it the chemo that knocked you off in the end? That's what I want to believe. Because if it wasn't that, then it might have been the high potassium level in your blood. When you visited me yesterday at the office, I told you that a level that high could kill you. I urged you to go to the hospital.
a treasury of compelling stories and poems.
Includes The Resilient Heart , Babel: The Voices of a Medical Trauma and Confessions of a Seventy-Five-Year-Old Drug Addict. Foreword by Maureen Bisognano, President of the Institute for Healthcare Improvement.
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