Tuesday, September 25, 2007


I had a rough night. For the second night in a row I had two patients, both of whom were extremely difficult to take care of.
Both are in a coma from brain injury.
Both have multiple wounds and sores which must be dressed.
Both are diabetic and require frequent blood sugar checks.
Both have gastric tubes for tube feeding.
Both are on respiratory assist.
Both have very serious bed sores which must be cared for.
Both have infections which are communicable by contact and so they are on isolation, meaning every time I went into the room, I had to gown up.
Both have lots of meds spread out so that every hour I needed to be in both rooms doing several things.
Both are incontinent of stool - you can figure out what that means for patient care.
Both had to be bathed and have their linens changed.
Both needed frequent mouth care.

Because we were short, I also had to take a third patient. Fortunately, she was stable with few issues to be addressed.

On top of all this, my fellow RN got a poor woman from a nursing home who came to the ER with intractable vomiting. He needed help with her.

However, none of this is what was difficult. I’m not usually this busy, but it happens sometimes. It is part of the job.

The reason the night was so hard was that early in the shift, as I sat looking at all the stuff I had to do and trying to organize it in my mind and on paper, an uninvited thought assailed me. I looked at the date on the computer screen, and suddenly realized that this time last year, I was going back and forth to New Orleans because my grand-daughter, Sande, was dying from ovarian cancer. She was only seventeen. She was my baby. When she was born, she had an incurable digestive tract disorder and almost died. But God intervened after the doctors had given her up, and in one afternoon she was healed.

I went to my son’s house as I did every day after work. I went to tutor my two older grand-daughters, and to hold Sande. I didn’t think she was getting enough attention. So, six days a week I spent two hours in the afternoon holding her with her ear to my mouth saying, “Paw Paw loves Sande.” Two hours a day. I wanted her to know. She was so sick.

So one Saturday I arrived to find Sande listless, almost unresponsive, and her fingers and toes were purple. I knew she was dying. I took her to my best friend, my adopted mother, who I called “my Little Black Mama”. She was an elderly black woman with whom I had become friends, best friends, intimate friends. And she knew God intimately. She helped me raise my girls. So I took Sande there and I said, “Mama, our baby is dying. I’m going to leave her here. I want you to take her to your church tomorrow morning and put her up on the altar and ask all those godly, praying women to lay their hands on her and pray for her healing.”

Up to this point, Sande had not been able to keep any nourishment down. We had to keep a bottle in her mouth 24 hours a day to keep her alive at all.

So Rete (the lady I am talking about) did as I asked, and brought her home. She called me later and said she was cooking beans on the stove, and when she got home, she poured off some of the pot liquor and fed it to Sande in a bottle. She kept it down. She took some milk and kept it down. From that time on, Sande could out-eat me. She was about four months old when this happened. When she was about two I stayed overnight, and she woke me early saying, “Paw Paw, I’m hungry.” She was pulling on me to get up and make her breakfast. So I got up and made her some oatmeal. And some more, and some more. I made her five packages of instant oatmeal. Then she looked up at me like a dying calf and said, “Paw Paw, I’m still hungry.” I said, “Honey, you’ve eaten everything in the house.” So then I had to take her to Huddle House and buy her breakfast.

I mean, when God healed her, He really fixed her good. She was like a vacuum cleaner with teeth. And she never got fat. Oi!

But in July of 2006, Sande started complaining about abdominal pain. But she complained about everything, so no one thought anything about it. By August, she looked like she had a full grown watermellon in her abdomen. The doctors thought it was a cyst. They scheduled surgery. They wanted an oncologist present just in case. About September 12, to our horror, this cyst turned out to be an ovarian tumor the size of a frozen turkey. She stayed in the hospital for a few days and went home. She was in intractable pain. Two weeks later was the return visit appointment with the oncologist to decide on a course of action. I drove to New Orleans to be present at the appointment. Sande had told the doctors that she wanted me in on everything because, “Paw Paw will make sure everything is done right.” When I got to the house, she was in horrible pain. I broke down and cried. I tried to refrain. By the time we saw the doctor, she was just miserable. He admitted her right away. They started her on a pain drip. The pain just got worse day by day. I was back home, but was in touch by phone.

For a week she was so drugged, most of the time she could not converse. But she would tell me that when she got better, she wanted to come visit me for a long time so we could sit on the back porch and talk about a lot of things. I knew that would never happen.

Then I got a call that she had been taken into emergency surgery. They had transfused about a dozen units of blood and her hemoglobin would not come up. When they opened her abdomen again, they found tumors growing like toadstools all throughout her abdominal cavity. And they were bleeding. Why wasn’t God healing her again this time. What was the point of the first healing when she was a baby? I don’t know. I left for New Orleans straight away.

I got there a couple of hours post-surgery. She was stable enough that they were about to take her off the vent. I made them wait until her father got there -- just in case. But she came off alright. But her pain level was so high that they had to knock her out to keep it under control. When she was still awake, she told me she did not want to die. What could I say?

I had the sorrowful job of telling her father that he should sign a do not resucitate order and, unless there was marked improvement, should refuse chemotherapy, because it would only prolong the agony.

Hours turned into days. She sunk further and further. I did some nursing care on her that the staff nurses just did not have time to do. I waited with the family. I went back and forth to my room at the inn attached to the hospital. On the last day, I started checking her urine output every hour. I could tell we were winding down. At about two p.m. she started to turn blue and cold, even though she was still breathing. At five p.m. her urine output was only five mililitres. I told them to go get her father, that she was about to go. At five forty-five she expired. She had lived just less than a month after the first surgery and only a few days after the second.

And where was God? Well, He was right where He was when His Son died at the hands of His enemies -- brutally, mercilessly, vengefully. And I think that, since I taught my girls to know the Lord from the time they were born, that He will raise her up on the last day as He raised up His Son.

But that does not help my feelings. It does not make me feel any less disemboweled, any less cut down.

And I have hoped all year that when this time came around, I would not be stalked by these unbidden memories.

But as I sat trying to organize my patient care (remember that way back when I started this?) these things, like a banshee riding a black horse, came screeching, galloping through my mind.

God hath not promised
skies always blue,
Flower-strewn pathways
all our life through;
God hath not promised
sun without rain,
Joy without sorrow,
peace without pain.

But God hath promised
strength for the day,
rest for the labor,
light for the way,
grace for the trials,
help from above,
unfailing sympathy
undying love.

Helen Steiner Rice

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