"That boy’s going to die and he knows it," said one of the other nurses. "This is one of those times that a coma would be a good thing. Look at his eyes. Why can’t they do something?"
I’d been looking into those eyes for days. Twelve-year-old John had a ruptured appendix with major complications, not something we expected to kill a child with the kind of antibiotics available. But he continued to deteriorate, gangrene set in and the smell of death crept into the corners, in spite of all our efforts.
I glanced out of the ICU window. All I saw was a strange, gray world with little color except the narrow houses smashed next to other tall narrow houses perched on the edge of steep hills. The houses looked as if they’d tumble down with the slightest wind from a passing cardinal’s wing. Clouds stretched across the sky like dirty rags.
In the late 1970’s my husband Karl took a new job as a respiratory therapist in Butler, Pennsylvania. We moved ourselves and children across the country from the Oklahoma Prairie to a small industrial steel town and I went to work in the local, union controlled hospital.
At first I loved the hills, being from flat land, and the tree colors during indian summer made me want to get out paints and capture everything on canvas. But snow came in October. It never left. Streets turned black and gray as the city sprinkled coal dust on the snow for traction. I missed the wide open, warm Texas skies. I dreaded going to work.
Tension laced through ICU like we’d all been caught in a net. Our young patient’s parents and physician had the same glazed looks of disbelief that said, "How can this be happening? Why is this happening? And the unspoken questions, "How can God not help him?"
The entire staff of ICU took turns staying with John and his parents so that a nurse was at the bedside, touching his hand at all times. John’s parents looked at us with unspoken questions in their eyes. "What can we do differently that we haven’t done? What did we do wrong?"
Every time I looked at John, I saw my son, Jeff, almost the same age. I pictured Jeff sick and me helpless. I could hardly stand it. It was like watching my own son die before my eyes.
Other nurses felt the same way. We tried not to get too involved with our patients. The emotional toll could be too great. But detachment didn’t always work.
"I’ll come in early, I can’t sleep anyway."
"Tom has to work this evening, I can stay late with John."
Nurses volunteered to work past their time to leave, came in early. We couldn’t stand the idea of leaving him alone and we were frustrated by our inability to change the situation. "How can we help him? Why can’t we help him?" We had strict visiting rules in ICU at that time, but we broke them all, letting his parents stay around the clock.
John didn’t make it, in spite of our efforts. He died at 5pm and I worked the rest of my shift on auto pilot. The normal back and forth bantering that keeps the ICU tension at bay died with John. All of us worked, doing what we had to do, saying little. The smell of gangrene still lingered in the air.
As medical professionals we knew we couldn’t save all of our patients. But death should have exceptions. It should never come for children.
I can’t keep doing this, I thought. ICU is too hard. It’s like I watch my own children die over and over.
I walked home that night, Christmas Eve, seeing a gray world, trapped hundreds of miles from family, smothered by hills that closed in more tightly each day. Just as I reached our little blue house, music sang out from the small church across the street.
That seemed strange. They never chimed at night. I turned around when I reached the top of the stairs to the porch. As I looked at the church, a full moon slipped from behind the ragged clouds and lit the snow with a blinding glow. Light glinted from the stained glass windows and shone off the cross on the steeple. Stars winked between the clouds.
I had to accept life as it was, full of hope and of mystery, things we’d never understand. I wasn’t deserted and neither was John or his family. God was with them and with me.
I just needed a push, a different perspective, new light on the subject. My view shifted and I was able to see the beauty in the snow, the hills and in God’s Plan. I didn’t have to always agree or understand. If I looked for the beauty, it was there, in the flash of a bird’s wing, the smile of a child and in the sound of a chime.
John’s parents found the comfort they needed and I faced the idea of going back to work, dealing with the everyday stress and strain of nursing. I found new eyes by which to view my world. Whenever my sight got clouded again, and it’s happened over the past 40 years of nursing, I simply listen for the chimes in the snow and my vision becomes clear again.