“Doc, he’s gone.”
Working as a hospitalist, I had a list of patients to see for the week. This was my first day back at the hospital, and so all the patients were new.
Joe was on hospice care. The hospice facility was full. From the medical record, I could see that he was comatose. After a large stroke and a week of waiting, he did not wake up. He had kidney failure, and his body was building up with toxins. He had no family locally. A distant nephew had been contacted. There was nothing medically for me to do for Joe, but just the routine, see him and write a progress note for the day. I checked in with the nurse. Nothing new today. He would remain in hospital. Comfort measures only.
I walked into the room. There were two beds in the room. The window bed was empty. Joe was in the far bed from the window. He was a large pale white man, neatly-combed clean white hair, eyes closed, no response to my entering the room. The nurses had tucked Joe under the covers in a way that reminded me of the way babies are swaddled. His breathing was slow and methodical. I put my hand on his chest. Felt the rise and fall. There was no reason for me to “unswaddle” him.
I looked out the window. It was a sunny Florida day, green and beautiful. I was stuck inside today, but at least there were windows. I had the sudden thought to do something. As I stared out the window, I spoke silently to Joe. “That is the way out. It’s OK to go.” It was less than a whisper, just a thought. “That’s the way out.” There was nothing more that I could do for Joe. So I just spent a moment with Joe, feeling his presence in the room, and staring out the window. “That is the way out.” Time slowed and expanded into this quiet space. I could hear the faint chirping of birds in the trees outside the window.
I went back down the hall. The hustle of activity at the nursing station contrasted with that moment of peace. I sat at the desk by the computer, picked up Joe’s chart, and began to write a note.
As I was just finishing, the nurse came to tell me, “Doc, he’s gone. He just passed.” We exchanged a glance of relief. It was not that he was suffering, but that it was time. He was now at peace.
I updated my note. Signed the death papers. Called his nephew.
That entire day as I saw the rest of the patients on my list. I had the sense of something that I can only describe as a blessing. The feeling descended on me in the moment the nurse said, “Doc, he’s gone.” I had the sense that I had done the only thing that I could for Joe, and that perhaps … just perhaps … it had helped.
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