I hadn’t thought much about talking to the dead before, but who really thinks about that? I’d really never been around a dying person before, except from a distance as a nursing student. I was now a brand new RN, with a bright, shiny, new career. I was up close and personal to patients, finally, after a long training that I’d thought at times would never end. But it did, and I graduated, and was fortunate enough to land a job in an urban hospital. And like many new nurses, I was assigned the primo shift: the night shift, on the medical-surgical floor. It’s a good place to see a wide variety of patients. Most med-surg patients get better and go home. Some don’t. But I saw and learned a lot from each patient. Some things that I saw and heard, I wouldn’t have believed had I not seen with my own eyes and heard with my own ears.
The night shift is an eerie time to work: most people are asleep. The body wants to sleep, but night shift workers walk through a hazy world that most people aren’t aware of. The lights and the voices are kept low, to allow patients quiet and privacy so they can sleep. On one eventful night, I sat, unsuspecting, at the nurses station, charting. Across the hall, a very ill gentleman lay quietly in his bed. The door to his room was open, but the privacy curtain was drawn. It was 2 a.m. All seemed peaceful, all seemed to be resting comfortably in their beds, including the patient across the hall.
The gentleman was assigned to me. I was responsible for him for the duration of my shift. I had checked vitals on each of my assigned patients, passed medications, checked IVs, done my routine rounds, and returned to the nurses station to document on each patient’s status. It was nearly soundless. No sound was a good sound to hear, at that time of night. No sound was soothing, and seemed to whisper, “All is well.” Sometimes is was.
But some of the most profound things begin in the quiet, subtly, unnoticed. At first, I heard nothing except the sound of sleepy breathing from my patient across the hall. Then, I heard him stir. I crossed the hall and peeked into his room. His eyes were half-open, and he seemed unaware of my presence. He stirred again, and his eyes opened wider. He seemed to stare with great concentration at the empty ceiling above his bed. I switched the light on dim, and approached his bed. Still, he seemed unaware of my presence. I quietly checked his blood pressure, listened to his heart and lungs, asked him how he was feeling. He didn’t answer, just closed his eyes again, and seemed to return to sleep. I returned to my chair at the nurses’ station, and pulled the patient’s chart off the shelf. I read through recent documentation by other staff members who had cared for him, then turned to the page that told me who he really was.
The gentleman across the hall continued to sleep quietly, as I read that he was a retired railroad worker. He was married, had 3 grown children, and I noted in the charting that his wife and children had been to the hospital to visit several times during his 5-day stay. He had been hospitalized for severe congestive heart failure, and was not responding well to his treatment. He was declining, and as he did so, his family had continued to visit, sitting for hours at his bedside, holding his hand, talking soothingly to him. The staff reported in his chart that he was alert, oriented to person, place, time and situation, but had shortness of breath when speaking. His heart was becoming weaker, was having more difficulty pumping his blood through his body. Any activity caused difficulty breathing. But according to the chart documentation, he continued to be lucid, responding appropriately to questions.
Out of the quietness, I heard someone speaking, slowly. I turned in my chair and looked around me, thinking another staff person was in the area. I saw no one. The voice continued, softly at first, and I had difficulty understanding what was being said because the speech was muffled. I realized the voice was coming from the direction of the room of the gentleman across the hall. Had someone come up from the lab to draw blood? Had a visitor slipped in? The lights in the room were off, too dark for a lab draw. An unlikely time for a visitor.
As I listened, I had difficulty following what was being said. Not because I couldn’t understand the words being spoken, because I could. After several minutes, I realized I was hearing only one side of a two-sided conversation. Or was he talking to himself, I wondered? The gentleman’s labored speech became a bit more rapid, a bit more agitated. He paused to catch his breath after every few words. Then he would wait. For what? After a few moments, he would speak again, and I began to discern questions, as I strained to tune my ear, trying to understand what was being said. It was as though I was hearing only one side of a telephone conversation. I had trouble interpreting what was being said, not because it was confused or didn’t make sense, because it did seem to make sense. If I imagined only being able to hear one side of the conversation.
I rounded the nurses’ desk and crept slowly and quietly toward his room. I stood at the doorway, and with a single finger, parted the privacy curtain, just enough to see the gentleman lying in the bed. His eyes were open, and he stared at something on the ceiling above his bed. He seemed to be in no physical distress, but involved in an intense discussion with someone.
“How will she ever do the bills?” he demanded, and his arms gestured outward, palms turned upward as though in question. “She’s never even done the checkbook.” He paused, as his labored breath eased, but never turned his eyes away from the ceiling.
“Well, I can’t go now!” he stated, resolutely, as though a firm decision had been made. He seemed to listen to something I could not hear. A tear slid down his left cheek. His gaze turned slightly to the right, where it stopped. He smiled weakly. “Dad,” he said. He held his right arm out, as though reaching to touch something. He was quiet for several minutes, then he said, ”I know. I know.”
I struggled to understand what I was seeing and hearing. I looked around myself to find another staff member that might be able to help me figure this out. I was alone. I turned my attention back to the gentleman lying in the bed. He seemed to have relaxed. His breathing seemed less labored.
“The kids will help her, I know,” he said, with obvious relief in his voice. He continued to look to his right. “Thanks, Dad.” It occurred to me, with a physical jar, that his father must have been long dead, as my patient was in his late seventies.
My patient turned his gaze back toward the ceiling, directly above his bed. “Ok,” he said. “When it’s time, okay”. There was calm and resignation in his voice. He closed his eyes, and I saw his body visibly relax as he seemed to drift off to sleep. I watched for several minutes, and when it was clear he was comfortably resting, I returned to the nurses’ station. I reached for his chart, and hesitated for a long while, trying to decide what to document in regard to what I’d just witnessed.
Finally, I signed off on the entry. “Patient resting quietly, 0230.”
When I returned to work the following evening, the bed that had held the gentleman across the hall from the nurses’ station, was empty. In report, I learned he’d died early that afternoon, his wife and children at his bedside. The nurse who gave me the report, and who had been present at the time of the patient’s death, said that just before his death, the daughter had promised her father that she would take care of her mom, that she’d be sure the bills were handled, that he shouldn’t worry, that he should just rest, and not worry. The nurse said that shortly afterward, the gentleman had closed his eyes, his hand still enfolding that of his wife, and died.
I hadn’t learned about this in nursing school. Perhaps what happened with the gentleman across the hall was something that cannot be taught or learned, but must be witnessed or experienced to be known. I’ve often wondered, who was the gentleman talking to? Of course, I’ve never come up with an answer, but I know he was engaged in a very serious conversation with someone. I suppose it isn’t important that I understand to whom he’d been speaking. He seemed to have gotten his answers, and died in peace.
Had I not seen and heard the conversation, I wouldn’t have believed it. Somehow, I don’t need any more specific answers as to whom and how and what. It’s enough for me to believe that sometimes, the dying talk to someone we cannot see or hear. There’s comfort in that for me. I know there was for the gentleman in the bed across the hall.
©Janet Mitchell, September 2011. Any resemblance to any actual person, living or dead, is entirely coincidental. This is a work of fiction.