By Elizabeth Hanson
She is thin, frail, and sickly when I meet her. The right side of her chest is tattooed with a dark purple bruise that spreads up her neck – the aftermath of her port removal. She is tethered to an IV pole by multiple infusions of antibiotics, vasopressors, and fluids. She is bald. Her husband is next to her bed, his skin rough and tanned, shadowed by white hair and a stiff beard. He is feeding her watermelon with a spoon as she smiles when I walk in, her smile lighting up the room.
She tells me that she feels okay today, that she is sore where they pulled out her port, but that she knows it had to go because of the infection. She tells me that she doesn’t mind the bruising, that she thinks it’s even starting to fade a little already. Her husband jokes that it makes her look tough, and she laughs as he offers another chunk of watermelon to her lips. He says he is thankful things are looking better this morning. She says she agrees, and that the watermelon is as sweet as can be. They sit together in the ICU the way an old couple sits together on a back porch sipping coffee at sunrise – as if nothing else matters.
She has cancer refractory to all therapies. Her infection is treatable though, and in three days’ time she leaves the ICU. Her husband walks beside her bed as she is rolled down the hallway. He reaches over the railing and their fingers entwine. She glows when they touch. A cautious smile forms at the corner of his mouth, subtle but suitable. He squeezes her hand, and together they go.
She returns in a week when her kidneys fail. Accompanied by her husband and a friend, she is sleepy and pale and unaware of their presence. A watermelon container sits between them, its lid tightly sealed. She is started on dialysis but she does not get better, her eyes blank and gray. Her mouth hangs open, her death rattle floating through the air, audible from the doorway. Her friend sits in the corner as her husband stays by her bed watching, waiting, hoping, and holding her hand as if this may instill her with new life. He bows his head when I tell him I think we need to talk. Yes, he says, I think that we do.
I expect anger and sadness when I tell him she is dying, that we have tried everything, that the dialysis and infusions and poking and prodding are causing more pain and harm than good. I expect sniffling and tears. But he nods in understanding. He lifts his wife’s hand between his palms and kisses it gently. And then he turns to her friend. How about this, he says. Why don’t we go downstairs, to the café, and split a pizza. How does that sound? Split a pizza and call the family. And then, we can come back to say goodbye. They walk out of the room, and I am left alone with her, surrounded by my thoughts and curious notions of what it means to be human.
Elizabeth Hanson, M.D., completed her residency in emergency medicine at UAMS and is currently a second-year critical care fellow. Outside of work she enjoys writing, drawing, and spending time outdoors.