HOW-TOS FOR HOSPICE NURSES |
Denise Napoli Long
Put on your uniform—scrub pants, scrub shirt, ID badge around your neck, plastic clogs with pineapples on them, for flair.
Drive to a patient’s house. Today it’s a big, sprawling ranch, new grey siding, daylilies just beginning to wilt, circular gravel driveway with a Mercedes and a Land Rover parked close to the front door. A signpost in the hostas that says Nana’s House, Nana’s Rules.
Park your Kia behind the Land Rover. Open your laptop and check the chart one more time. Find, in the clinical documents, the patient’s certificate of terminal illness. Read that it’s ovarian cancer, with metastases everywhere, cancer in the lung, in the liver, in the brain. Read that she fell last week and ended up in the hospital, got back yesterday. Read that her daughters are “very involved,” which is code for too involved, which is code for annoying, which is code for very, very, very sad.
Put your phone on your dashboard. Put your keys in your pocket. Take a deep breath. Get out of the car, and lock the door, because rich people are sneaky as hell.
Ring the bell.
Enter.
Be led to the patient’s room by one of the sad daughters who, you note, is stunningly beautiful, with shiny black hair that skims her shoulders, and dark eyes, and delicate cheekbones, like a doll’s. Realize that her beauty makes this harder for her, because it’s distracting, and everyone who is present here will either be resenting her, or envying her, or wanting her.
Wonder: which are you?
Be admitted to the patient’s room where the other daughter, less beautiful, sits in a folding chair, her head in her hands. Note the dresser whose surface is covered with medical supplies, gauze and tubes and drains and vials of medicine. Note the curtains—beige, drawn. Note the framed photos of grandchildren that have been piled up on the floor next to the bed, to make room.
Say Hello, gorgeous! to the patient even though all the new policies say that we are not to call patients Gorgeous, or Honey, or Darling, or Handsome, or Sweetheart, we are only to call them Mr. So-and-do, and refer to them as clients, as if we are at a bank and I am taking their mortgage applications.
Smile as the patient opens her eyes and nods back at you and then closes her eyes again, her brows furrowed, her lips pursed and straight. Grimacing. Note that her stomach is the size and shape and hardness of a boulder. Note the two tubes snaking out of it, one draining something the color of grass in springtime, the other coiled around itself and taped down alongside her belly button, so as not to pull out from wherever it’s lodged inside her.
Drain the tube with the green. Drain the coiled tube. Note that the fluid coming out of the latter is candy-pink, like a watermelon jolly rancher. Assume that it’s blood. When the daughter asks if it’s blood, say, Probably not.
Give the morphine. Give the lorazepam. Show the daughters exactly how you’re doing it, tucking a pill into the corner of their mother’s mouth, massaging her cheek until it’s gone. Smooth the patient’s hair. Take her blood pressure, and hear nothing, and enter a fake number into the computer.
Step outside into the hall. Tell the daughters that you’d guess their mother has a week, or maybe two, but you don’t know, no one knows, it could be anytime. Think to yourself that it will probably be much less. Think to yourself that it will probably be another day or two before she won’t open her eyes at all. Don’t say that. Think, What’s the use. They’ll find out soon enough.
Smile when the one daughter, whose name is something like Rose or Daisy or some kind of flowering foliage, you can’t remember which, says you’re bubbly. Wonder if anyone outside of this context has ever, in your forty years of life, called you bubbly. Doubt it.
Squeeze the other daughter’s arm when she says that she sort of can’t wait for it to happen, she knows that sounds horrible, but clearly her mother is suffering, her mother would never want to live like this, the daughter wishes it would just be over, is that so terrible?
Say, You’re doing a good job.
Leave.
Wave from the driver’s seat of the Kia at the beautiful daughter in the doorway who watches you go. Turn on the radio. Get out of the driveway and halfway down the street and then turn it up as high as you can stand. “Raspberry Beret,” by Prince. Drive home.
Take off your scrubs. Wait on the front stoop for your kids’ bus with a cup of coffee leftover from this morning’s pot. Make them dinner. Turn on cartoons. Put in a load of laundry. Walk around the house picking up toys, unpacking backpacks, clearing plates. Give the little boy a bath and get the big boy in the shower. Help them put on their pajamas. Read two Berenstain Bears books to the big boy and one book about a train named Tootle to the little boy. Say goodnight. Close the door.
Pour the whiskey.
Remember the way the woman nodded at you. Remember the brightness of her eyes against her ashen skin, the way her lids closed over them when she fell back asleep, the way her cold hands rested on her stomach, the way her mouth fell open.
Close your eyes.
Dream that she asks a question, but what, exactly, you don’t know, because her voice was so low. Dream that you let yourself tell something to the daughters, something vital, something real, something helpful. Something damning. Dream that they understand you, and you understand her, and her face is someone you remember from childhood, and the room is a room you’ve been in before, and the photos on the floor next to the dresser have your children in them.
Wake in a sweat.
Do it again.
Call her gorgeous, gorgeous, gorgeous until the end.
Denise Napoli Long is a home hospice nurse, an ER nurse and a volunteer EMT. She is currently enrolled in the masters in writing program at Johns Hopkins University. She has previously been published in Intima as well as Write or Die magazine.