Not It _ life support

 Not It

Feeling powerless and full of doubt, plus wrestling with the concept of "God's Will" while my wife lay in a hospital ICU hooked up to a ventilator.  Things looked and felt bleak.

( A vacant church on a hill in Jasper, Ohio.  Photo by Fred Rutter _ 2024 )

            My partner, my wife, my best friend was lying in an ICU hospital bed while hooked up to a ventilator.  She was there alone and scared beneath all the sedatives, while I was home with a painful void growing inside me.

            Few of us have a vision of how we will come to our end – but this was not it.  As a matter of fact, this was the exact opposite of any possible scenario we had envisioned for each other.  Of this I was sure, for we had pledged never to let this happen to either of us – yet here we were.  Apart and each alone, one painfully aware, the other unconscious and supported by technology.  This trepidation of being placed on a ventilator was not just some amorphous dread. Most of my wife's life had been spent as a hospital nurse, so she had an insider's knowledge of some of the negative aspects of relying upon such a lifesaving device.    It was every bit as horrible as either of us had imagined, plus my sense of guilt glazed the whole moment.

 

             The ventilator was removed after four days, but that proved to be only a brief reprieve from her tethered life for she quickly slipped into respiratory arrest.  During that fleeting moment, she was fully present and was able to whisper to me, “I am dying!”  I was not sure if it was a statement of intent, or a declaration of the truth, so I asked her if she wanted to.  The love of my life stared back in panic as she gasped for breath.  I raised the back of the bed and suctioned her airway to make it easier to breathe, then looked into her frightened eyes while she repeated the heartbreaking phrase.  To be absolutely clear, I asked, “Do you want to end this way?”    She slowly shook her head ‘no’, and I told her the vent would be put back in to relieve her agony and alerted the ICU pulmonary team of her distress.

            A highly choreographed group quickly assembled in the room and began the process of re-intubation.  A check list of people and functions was annunciated, confirmed, then repeated.  Time was called and the process commenced.  First, the administration of ROC to paralyze her, then sedatives, both short acting and continuous, followed by clearing the airway and checking with an illuminated scope, then the intubation, securing the tubes and adjusting the machine settings, followed by securing the patient to the bed.  I remarked to the certified physician’s assistant, with whom I had been conversing during this performance, that it sure did not look like how it was portrayed on television, for it was much more complex.

 

            Had my love’s agony been relieved?  She was unconscious and sedated, so there was that.  However, my fear was that it had only been delayed.  I was not able to comfort her or tell her that I loved her – which caused the greatest pain of all.  My trying to be strong for her, to save her, erased the emotional support and reassurance I dearly wished I had conveyed.

            How would this end?  I had a strong premonition, and it was not supposed to be this way.  My promise to never put her on a ventilator had been broken, not once, but now twice.  At least with the second time I knew she wanted to live, but that did not offer much succor.

            Would the last words I ever heard from my partner of three plus decades be, “I am dying”?  And would the last words from me be my seemingly unfeeling query.  Sitting back at home, engulfed in the humid darkness of the oppressive summer night, it certainly felt like those words would be the last we would share, which was very unsettling and unnerving.  Couldn’t I have left her with something more uplifting to carry to the next dimension?

            Another thing was troubling me as well.  Shortly after arriving home late in the afternoon, I received a call from a doctor requesting permission to insert an arterial catheter.  He explained that her blood pressure kept dropping to dangerously low levels and this procedure would allow them to better monitor the pressure as well as administer stabilizing drugs more rapidly and effectively.  I consented.  

            The stress of all that had transpired this day tightened its grip harder, and it occurred to me that her declining blood pressure may have been her body’s way of saying her time had finally come.  That would be a more peaceful way to leave this realm than suffocating through respiratory arrest.  Now I had subverted this quiet exit as well.  Stress, fear, and guilt do not make for a pleasant sensation.

 

            Was my complicity in modern medicine and technology preventing God’s will to be done?  I felt this may have been the case.  My selfish desire to keep my sweetheart around, and hopefully be able to express my love once more, had eclipsed her chance to disembark from the trainwreck of her life of the past several months in a dignified way. 

            Where was the life, or the humanity, in the artificial and mechanical existence she was now enduring?  The line of demarcation between the two was not clear, though I suspected there was less Tammy, and much more technical intervention in the person in that faraway bed.  Could it be painlessly reversed, or did the drama of the previous extubation offer a look at how this would probably end if the ventilator could never be safely removed again?  How devastating!  In my attempt to save her I had already lost her and missed an opportunity to connect one last time in a more meaningful way, or guaranteed an existence upon artificial life support.

 

            People who have faith ultimately have to confront a number of difficult questions – one being, “what is God’s will?”  I cannot claim to know that.  However, I do believe that to move in harmony with the universe the best I/we can do is try to treat all things with dignity and respect – to try to do the next right thing.  That may have the aura of a platitude but moving through life situations with this intention is hard to do with consistency.  I fail often and frequently second-guess my actions and motives.  Clarity is not readily apparent.  If I profess to know or understand God’s will then I am playing God myself – and what if I do not like how a situation has evolved?  What then?  The best I can do is to accept – period.

            The situation with my wife on a ventilator – was that God’s will?  Maybe.  Questioning the reality of a situation does not do anyone any good, nor does it resolve anything.

            So, instead of divining the ‘will’, I try to be cognizant of God’s grace – those wonderful things which happen all the time whether I am paying attention or not.  Awareness, acceptance, faith and belief are some of the foundation stones necessary to experience and feel the blessings of grace.  That is a powerful form of life support.

 

            Just such a blessing presented itself upon my arrival in her equipment-filled room the next day.  She was the most alert as I had seen her in over a week.  The unknowing vacant stare was gone, and the real Tammy was looking back.  Seizing the opportunity we were blessed with, I told her I loved her – and meant it.  Being able to express that changed my attitude, which lowered my stress and anxiety over the recent past.  It was as if by being able to do that, we were now free to move in whatever direction this journey would lead us.  I was also well aware she probably would not remember the moment.  Four days later the ventilator was successfully removed, and three days after that she was discharged from the hospital.

            Her health crisis is far from over, and her memory of how we got here is a blank.  My telling her the outline of the events only fills her with fear, so I have stopped trying to explain.  In spite of trepidation of the future, and experiencing the bewildering state of her condition one day at a time, she thanked me for saving her life by making the decision I did – which put us in a situation neither of us ever wanted to be in.  That does not absolve me of doubt and second-guessing, but that assurance certainly was appreciated.

            Pride, ego, control, and self-serving motives get in the way of me doing the next right thing, as does my inability to see the big picture, or all the facts and how they interact.  None of us can, which is a frequent source of frustration within us all.  I must be open and welcoming to the blessings and grace my Higher Power continues to let flow, even as I fail to recognize or appreciate them as they happen, and just leave it at that whenever possible.  Resign from the debating society.

            So, this was not it.  The scary episode was not how we ended our fulfilling partnership, for that final chapter still waits.  My best friend is struggling but making incremental progress.  The same can be said of me.  Together we carry each other - one day at a time.

           

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