A sage of ancient India, when he felt the end of his days approaching, left everything he knew to wander in the forest. Coming across a forest fire he entered into it and gave up his life in this way. I have always been attracted by such stories. When I contemplate my own death, I imagine wandering around Govardhana alone and anonymous. I would cover myself in dirt or ash to disguise my complexion and then walk here and there, barefoot and without self consciousness, leaving myself in the palm of Krsna, suffering or not according to His sweet will…
I stand with two other nurses around the bed of a young man who was shot through the head while sitting in his car. It was done by a passenger, presumably an acquaintance, but no one was sure who. Our patient was paralyzed from the nose down, able only to blink his eyes. When asked to blink once for no and twice for yes, he consistently blinked twice when asked if he was in pain, but this was the extent of his communication. I tried running through the letters of the alphabet with him to get the name of who had shot him (It was not really my place to do so, but I felt compelled), but I did not get the same letters twice and had to conclude that he was not present enough to be able to answer the question.
We had come to his bedside to pull him up in bed and turn him. We contemplated his predicament. One nurse mentioned that he had seen a movie that had been shot from the perspective of a person in the same kind of condition. “Well that is very interesting,” replied the third nurse, “but if it was a movie of my life, the screen would just be black.” She would not accept life in such a condition.
I felt she was missing something, but did not say so. How often do we really get to choose the circumstances of our death? Some people definitely do. Some definitely do not. The rest are somewhere in between.
Nurses fear hospitalization.
In my first year of nursing a male nurse ended his report on a patient who had been in miserable condition in the ICU for months by spontaneously confessing that he kept a syringe full of insulin at home and that he had instructed his wife to inject him with it if he ever ended up in the ICU. Independently, a second male nurse made a similar statement to me under similar circumstances. Female nurses are more likely to say things like, “I hope my family doesn’t love me this much.”
Some trauma nurses do not wear their seatbelts. They would rather die than end up as a trauma patient. Burn nurses do not allow their children in the kitchen while they are cooking. Curiously, respiratory therapists tend to be smokers. I have yet to meet a nurse who says they would definitely get a liver transplant if their liver failed. “I would have to think long and hard about it,” is the closest I have come. (I have always asked the question in the context of caring for a patient with a failing transplant).
As far as I am concerned, I am not so worried about air hunger or avoiding pain. I think death is intrinsically painful and I am not so convinced that covering up the external expression of this with drugs really makes for a better death. I am speaking for myself now. Why drag it out? I would rather just get it over with quickly and naturally. I hope that when the time comes that I am able to make these choices for myself. If I am helpless, I hope I am still able to express myself. And if I am able, I hope that I will be listened to.