Pieces of a Dream.

Now and then I lose my way

using words to try to say what I feel

love is real

oh, love is real

I might as well

sign my name on a card 

which could say it better

Time will tell

'cause it seems that I've done 

just about all that I can do

I know that I'm living 

for the love of you

Every, every day I'm living

 for the love of you

Lord, knows I am

~ The Isley Brothers

_______________________

I did the thing I like the least yesterday. I shined a light into lifeless eyes and placed my stethoscope upon a quiet chest. I stood there frozen, lost in thought. The nurse beside me gently asked me for the time of death. I pulled out my cell phone, looked at the clock and stammered through a reply.

I've said it before that this part is hard. So final, so non-negotiable. But yesterday, flanked by my interns, that is exactly what I did. I pronounced a human being dead. And what I know for sure is that no matter how many times I do it, I am affected by it.

As well I should be.

Some hours passed and all of us were on to other hospital work. Discharge planning and consult discussions, speaking with nurses and deciding on treatments. All part of the daily whirlwind of hospital medicine that continues to swirl even after someone has transitioned from their earthly body to wherever you believe souls go. Just then, one of the clerks came to the doctor's room and asked for me.

"Dr. Manning? I think the family is preparing to leave and wanted to know if you needed to speak with them at all before they did."

And, honestly, I didn't have anything more in terms of logistics that I had to do. But I did want to put my eyes on them and honor my patient by doing so.

I went out into the hall and found one daughter standing there at the nurses' station. She was the one that we'd spoken to urgently when things took a turn for the worse. And also the one that was physically in the hospital when her loved one left.

I walked up to her reached my hand out to her. She took hold of it and spoke. "I was getting ready to leave and wanted to be sure you didn't need anything else before I did."

People were walking up and down the halls, nurses were speaking into telephones, and another patient was at the counter asking for pain medications. All of it so normal, so regular.

"No, ma'am," I answered softly, "I think we took care of everything." I squeezed her hand and looked into her tired eyes. "I'm so, so sorry for your loss. I want you to know that I truly am."

She seemed to appreciate that. Her eyes welled up with the most tears I'd seen from her all morning. She looked around the hospital ward and then nodded. "I appreciate all that y'all did."

I never know what to say to that so I just smiled in return.

She let go of my hand and just stood there for a bit. It was as if she was trying to leave but her feet had somehow become plastered to the linoleum. "Alright then, Dr. Manning," she finally said.

We idled in front of each other. Stepping aside to let a gurney go by but otherwise not really knowing how to move forward. It was weird because I somehow felt the same way. Like my feet were in quicksand. Finally, I said something because it was starting to feel awkward.

"Listen--please don't hesitate to call if there's anything you need, okay?"

"Okay."

"I'll be praying for your peace. You and your whole family."  And I said that because it was true. She seemed to appreciate that, too.

Eventually she convinced herself to shove off. I watched her walking away in the midst of the mundane Grady hustle bustle. She seemed a little lost near the elevator, even though she'd been there several times.

Oooph.

Just like a fist to my chest, I felt it. An ache--a very specific one--that I'd felt gnawing inside of me before. Ooooph. And just like that I was reminded of something. I understood why her feet were full of lead. Damn, I did. 

The night Deanna left us, I remember getting into my car to drive away from her home. Even with the unnatural sight of a big, blue coroner's van in the driveway, I couldn't take my eyes off of her car with the Delta tag on the back of it. Leaving would make it so final, so real.

Kind of like telling a nurse the time of death.

Turning off of Deanna's street that night was one of the hardest things I've ever done in my life. I think, of all the times I've cried about losing her, that this was the loneliest and most primal of them all. I even got lost leaving that evening because it was all so disorienting. I called my brother and he gave me turn-by-turn directions home. Even though I'd made that drive more times than I could even count.

Yeah.

So seeing that woman trying to wade through the emotion of all of that hurt me in the deepest parts. I knew there was nothing I could do or say to take it away from her. But I wished so bad that I could. So, so bad. I knew I couldn't, though. I almost went to her, but since we'd just met I didn't. I even considered walking her to her car. But now I also know that a lot of this is personal and delicate moments such as these can be tricky. I also know first hand that there has to be a first time leaving or a first morning after. There has to be.

But, if you're lucky, you do wake up. And with every new morning I take comfort in knowing that there are new mercies awaiting me. This gave me comfort for my patient's loved one, too.

Yep.

I managed to get through that without crying. But my dry eyes didn't last long. . . .

Nope.

My first day on the hospital service is always like a reunion of sorts. I see my favorite nurses and clerks and transport people that I don't see as often while in the clinics. So the day is usually filled with hugs and laughter and showing pictures of my kids and seeing theirs, too. And all of it is good.

Yesterday, I saw one of my favorite nurses, Ms. Nix. I've known her since my very first year at Grady and she has always, always taken extra special care of me. I mean that. She was an angel when I had both of my boys and even crocheted each of them special baby blankets that I still have. When Deanna left us, she heard about it and found me in the hospital. The hug she gave me seemed to be infused with an energy that is impossible to describe. I was deeply, deeply moved by her genuine support--especially at that time. She reminded me that we don't just work together. We are friends.

Ms. Nix told me that yesterday was her last day at Grady. And let me tell you--she told me that RIGHT after I'd bid my patient's loved one adieu in the hall way. RIGHT after.

So, yeah. You know how THAT went.

I got myself together and told her what she meant to me. I thanked her for being such an outstanding and dedicated nurse for so many years. I let her know that I felt honored to learn from her and care for patients with her and how relieved I always felt when she was assigned to any of my patients. I was specific about things like her professionalism and thoughtful communication. Then I let her know that her support and friendship was the best part of all. That she didn't have to remember that my sons' names were Isaiah and Zachary and that she didn't have to hunt me down to give me a card and hug me after I lost my sister but that I was so, so glad she did.

And she just wept and wept.

"You, Ms. Nix, are an exceptional nurse. And on behalf of me and every single patient we cared for together in this hospital, I just want to say thank you. Thank you for always going above and beyond and for being who you are. I'm really going to miss you."

This is exactly what I told her because now, more than ever, I know that life is short.

And yes. All of this sounds heavy, I know, but really, it was good. It was really, really good.

When I left work, I went to pick up the boys. They were in high spirits like they always are on Fridays. Isaiah was proud to tell me all about "Read Across America" day and to show off his Cat in the Hat look in honor of Dr. Seuss.

I did break up one argument over who of my children was "Thing 1" and who was "Thing 2." Zachary took great offense to being "Thing 2" and Isaiah let him know that "There just can't be TWO 'Thing 1s.'"  Which I mostly agree with.

Something about that little spat, I savored though. Just as I am trying harder and harder with every moment to savor all of my life. The ups, the downs, the highs, the lows. . . all of them pieces of my day, pieces of my life and, really, pieces of a dream.

 ****
Happy Saturday.

Now playing on my mental iPod. . . one of the best R&B songs every recorded and "soul" defined.