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I think of her often.
Long, dark blonde hair…
Frightened china-blue eyes
In such a young face.
She was 22, if memory serves.
Was a five-year survivor of lymphoma.
Against her doctors' advice, she became pregnant.
Because, more than anything else in life,
She wanted a Baby.
A baby she could hold and love and
Coo to…
Wrap its' miniscule fingers around one of hers
And inhale its' pink-baby smell.
A baby whose smiles would sustain her, whose cries would
Break her heart.
A wee one she could form and shape, watching it grow;
Correcting all the wrongs in her own life and
Providing the unconditional love she craved.
She did fine, up until the delivery
When Disaster struck.
She ended up in ICU, with me as her nurse.
I was one of the last to hear her speak…
All she wanted was to hold her baby…
To live, so she could see her beautiful little girl
Who'd been snatched away shortly after birth.
She kept saying "Please don't let me die…I have to take care of my baby…"
My hand to her cheek,
I promised her I would
Take care of her.
I did not keep my promise.
It was a fait accompli, you see.
Everything conspired against her.
The circumstances were all damned.
The intensivist on call stuck her far too many times to be safe,
Trying to cannulate a major vein under her collar bone for a large line.
She asked him to stop, and so did I.
I suggested other approaches for the stick.
He was driven, fueled by a maniacal ego.
To this day, he detests me for witnessing his initiating her end.
He knows I know, you see.
He dropped her lung.
She cried out, gasping for air…
Shrieking hoarsely "I CAN'T BREATHE…I CAN'T BREATHE".
Her small hand crunched my knuckles as I held it,
Feeling rage swell within me , impotent to help her,
unable to save her, horrified at what he'd done.
I wrestled loose to clap an oxygen mask on her,
As they prepared to intubate her. Her eyes were wild and pleading,
As she struggled to mouth the words "Don't let them do this…Please don't let them"..
Hot tears swelled in my eyes, racking sobs threatening escape. Every muscle in my body was wired and rigid,
and my chest ached with the need to scream at him.
I could not look at the doc,
Fearing my hatred for him would interfere with managing her crisis.
I tried not to take my eyes from hers.
She was so afraid, and at that moment, I was her only human contact.
The light extinguished in her eyes as the drugs began to work;
Her lids fluttered closed.
Her little hands slackened, loosening their grip on mine,
Her body relaxed.
She was peacefully,
Mercifully
Asleep.
And so, she went on a ventilator…
And never came off.
We never heard her sweet voice again.
We never again
Saw those remarkably expressive
Blue-sky eyes of hers
Searching our faces for clues.
We were all critical care nurses…
And damned good ones.
We snatched folks from the jaws of Death for a living.
We were not obstetrical nurses, however.
Women who've just delivered must have the height
Of their uterus measured every few hours;
And ,if it feels soft and boggy
It must be massaged firmly, to make it clamp down…
…or they may bleed and hemorrhage…
to death.
We all worked so feverishly on her,
Using every drug known to man
To maintain her heart rate and blood pressure.
We turned her, suctioned her lungs out,
Every two hours or more
Religiously.
We medicated her for pain,
Washed her like a child,
Stroked her forehead tenderly,
Brushed her hair and braided it,
Caring for her in the purest sense of the word.
We saw ourselves
And our own daughters
In that bed.
What some of us didn't do was measure her fundus…
Feel her uterus for its' height and mass.
The day I last took care of her,
I came in early, got report
And went in her room.
Her appearance shocked me,
I who have seen it all.
She was pasty-white and bloated,
Pretty little face misshapen,
No semblance of her "real" self.
My heart hurt, looking at her.
Shame and blackest guilt washed over me
Because I did not protect her from that intensivist.
I must live with that.
No matter how many lives I save,
how many hearts I re-start or bottomed blood pressures I rescue,
I must live with
The way I
Failed her.
I went about my assessment the usual way that morning,
Head to toe.
I wanted to believe
There would be something I'd find that others had missed
That would pull her out of this downward spiral and
Retrieve her from the coma she'd slipped into,
Imprisoning her.
I auscultated her heart and lungs;
I listened to her bowel sounds.
And then felt her abdomen for uterine height.
My stomach churned
As my hand sunk, enveloped by squishy softness.
Frantically,
I began to massage her uterus,
Desperate to make it contract.
As I firmly squeezed
Icy horror gripped me
Watching a scarlet arc of blood
Literally shoot out of her vagina
Into the air.
My knees went to water,and I gasped loudly;
my heart thumped in my chest
Knowing what it meant.
She was bleeding profusely.
As I yelled for help,
I reviewed the last few hours before my shift commenced.
Her blood pressure had been dangerously low,
Requiring emergency intervention,
And serious drugs.
The kind of drugs you give
when someone is trying to die.
In the hustle to revive her pressure,
Her uterus was forgotten.
Hours…..ticked by….
Lethal slackening of uterine walls
Having the luxury of time to
Allow blood to seep and pool.
I got her doc on the phone…
Massaging with one hand,
Cradling the phone with the other.
I begged for pitocin for her.
The obstetrician, her doctor of record,
Is a good man.
But he is not a critical care doc.
He feared making her blood pressure too high
With that drug.
He refused me, giving me a lesser pharmaceutical
To work with.
Pitocin would make her uterus clamp down hard,
Thereby ceasing bleeding.
It certainly would've raised her blood pressure, too…
Which would have been
A God-send.
God was cruelly silent that day.
He sent nothing.
There was no intervention.
No last minute miracle, no reprieve.
Despite the cold, leaden ache in my arms,
My massage only stayed the flood momentarily.
The moment I stopped, she began to bleed again.
My hands shook, trying to clean the pools of blood from around her,
Frantic to eliminate the fatal suggestion
Crimson lakes lapped at her pale thighs.
My gloves were smeared with her life-force, my scrubs spattered.
Ruby fluid dripped off the bed,
Garish on the ivory tile floor.
"GOD…!!!" I thought, almost calling Him out loud;
"Where ARE you, God ?…she has a baby…PLEASE don't let her die…
Please let her live and raise her child…its' all she wants… she survived cancer…she's come so far…..Please God, I beg you…Punish me in any way you see fit, Lord, but please let her live…"
My prayers were worthless.
She was motionless,
Alive by only the most technical of definitions.
We taped Polaroid's of her baby to the bed.
We talked to her about her baby, despite her coma;
Thinking it might spark a survival effort.
We begged the newborn nursery staff
To bring the baby to her…they would not,
Citing ICU as a dangerous place for a newborn.
The last day of her life,
I was off…I was not her nurse that day.
The nurse who had her
That Day
Went to the newborn nursery
And got
Her baby
And laid her on the girls' chest.
Her nurse tenderly arranged
The young woman's' arms around
Her Baby,
Acutely aware
This was the only Mothers' embrace
Her little girl would ever know.
She died
With her baby
Lying over the heart
That sacrificed its' own Life
To bring another
Into the world.
To this day,
I still consider
How we contributed
To her untimely end.
It knocks around in my soul,
Bruising and tearing at me.
I have no eloquent words or poetic phrases to tribute
Her short heroic Life;
Only the disturbing memory of all that happened,
Simply told.
Recently, my own daughter, about the patients' age,
Gave birth.
I hovered over her, vigilant for any threat ;
Much too mindful of
Those frightened china-blue eyes
Years ago.
I wonder
If
Her little girl
Knows
How much
her Mama
Loved her.
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