Lessons Medicine Seattle

Happy Thanksgiving.

Originally written in 2004. Remember all those things and people you are grateful for.

Happy Thanksgiving. You’re holding the slender and sweaty hand of your beautiful girlfriend. Her eyes are halfway closed and her entire body stiffens. Her head slowly turns towards the left. Her pupils are large, oh so large, making her green eyes that much more beautiful.

She’s seizing again.

The heart monitor shows her heart ticking away at 160 beats per minute—no, make that 170. Now 180.

The nurse, the mother, and the physician look at the heart monitor, as if it is some sort of oracle that will exorcise the spirits that have overtaken the body of this beautiful young woman.

Drugs are pushed. Her eyelids flicker, her body slackens a bit. She begins to mumble again. She picks at her sheets. Those green eyes show themselves again and she takes your hand, addressing you as her mother.

You take her hand, feeling that lovely warmth between your fingers. You stroke her hand gently as she continues to babble nonsense through the fog of her encephalitis. She begins to laugh—at what, you’re not sure—and you can’t help but laugh with her.

She’s right there before you, but she doesn’t know who you are. So all you can do is squeeze her hand again.

Happy Thanksgiving. Your sister has a brain tumor that has pushed most of her brain towards the left side of her head. She’s sleepy. She won’t wake up. She can’t move the right side of her body. She, of course, is not aware of this. You are.

Along with your mother, your church, her friends, and other relatives. You have somehow packed fifteen people into the room. There are ten more people outside, peering into the room. You’re crying. You’re trying not to. You’re worried that she’s suffering, that she’s in pain.

You ask questions about morphine—is she in pain? is she choking on her saliva? why is she making that sound? why is she breathing funny? What you really want to ask is When is she going to die? but you can’t because it just isn’t fair. She’s so young. Why does she have to have a brain tumor? Why does this have to happen today?

You ask for morphine—and the doctor knows that it’s not for your sister; it’s for you. You’re suffering for her. You’re suffering because of her. And you want to make it stop.

She’s too young to die.

“Nobody can predict when she is going to die,” the young doctor says with greater confidence than she actually feels. In fact, she is horribly terrified that she is going to say the wrong thing, that she is going to break fifteen hearts simultaneously. But she continues softly: “Just as every individual leads a unique life, each person dies a unique death. And no one knows when or how it will happen. But we will do everything to make her comfortable. And please let us know what we can do to help you.”

You burst into tears. It is that “D” word. That horrible “D” word that is going to steal your sister from you.

You don’t see the young doctor after she leaves the room—she travels through the stairwells, thinking about many of the things that are going through your mind. And you don’t know that this young doctor has never declared a death before[1. The patient in question did die on Thanksgiving. I declared her death. Every Thanksgiving, I think of her.] and may have to do just that, tonight, on Thanksgiving.

Happy Thanksgiving. There is a smorgasbord of Thanksgiving goodies in the hallway, in the nurses stations, in the Tupperware boxes that relatives and friends are bringing to the hospital. Little children are drawing pictures of scraggly turkeys with worn-down crayons. Elderly mothers are cutting turkey breasts into chunks to feed to their sons. Young daughters and sons are laughing with their fathers who are sitting in the ICU, wires and tubes encircling their bodies. Couples stare out the windows, talking softly, watching the light rain drizzle upon the dying trees towering over Seattle.

“Happy Thanksgiving,” I said into the phone. “I just wanted to call and say ‘I love you’, Dad, because, you know, you could be in the hospital today. And you’re not.”

“Happy Thanksgiving, Maria,” he replied. “I love you, too.”