Authors

  1. Gorman, Cynthia C. RN

Abstract

A meditation on fragility, loss, and resilience in patients, family, the natural world.

 

Article Content

A dead pine tree stood in our yard. For over a decade it had guarded the path to our front door. The salt winds from Hurricane Sandy that tore across the Long Island Sound and shredded our neighborhood had fried the tree's soft, heathery needles from blue-green to brown.

  
Figure. Illustration... - Click to enlarge in new window Illustration by Lisa Dietrich.

Last week my husband and I visited a farm stand and purchased a new tree to replace it. He has been so eager to make progress in restoring our little yard, which has been slow to respond to spring because of the beating from last year's storm. We made arrangements for the new tree to be delivered and planted the following week.

 

That evening I noticed that a robin had built her nest in the tree's branches. She did not seem to mind that it was dead, and perhaps she felt that its sparseness gave her a better view of approaching danger from the feral cat and fox that prowl the marsh across the road.

 

In the days that followed, it warmed my heart to see her shadowy figure meld into the branches at twilight and reappear with the dawn. She was my sign of spring after a long winter, my hope that the new lesion in my husband's liver might vanish like other spots had, my promise that the right nursing position for our life circumstances would materialize.

 

Rich suggested that we could move the nest to make way for the new tree. I forbade it, explaining that our robin would not return if we disturbed her home. When the owner of the lawn-care company arrived to discuss our spring cleanup, I showed him the nest and asked him to tell his workers not to cut down the tree until we were sure that the little ones had hatched and flown away.

 

The robin was on her bed of twigs Tuesday morning when I backed out of the driveway and headed to the hospital. Ashley and I took morning report, which heralded a hectic day. She moved so fast it seemed her white shoes were equipped with exhaust pipes. We had six patients, three leaving the unit for procedures, one discharge, and a new admission. All needed a lot of attention, but thankfully, meds were light.

 

JB had been admitted to our unit the previous evening with abdominal pain and failure to thrive. She was a 75-year-old woman with colon cancer that had metastasized to her liver. She lay motionless in bed, her silvery grey hair in tiny braids pulled into a ponytail high on her head. Her fingernails were painted dark red and were so long they curved into talons. I had to thread my fingers through them to hold her hand. She was producing droplets of dark urine in spite of the bags of normal saline we hung one after another.

 

Her husband, daughter, and son were at her bedside, struggling to come to grips with their mother's illness. They knew she was dying and were steadfast in their determination to support her wishes for no futile medical interventions. Their resilience was an assurance that they would help one another through the sad journey ahead.

 

We cared for JB gently, forgoing vital signs and finger sticks, and turning her every several hours. With each positioning, one of us would retape the laminated picture of her mother to the side of the bed she was facing. Looking at that picture seemed to calm her.

 

Her pain became severe as the day wore on, and she begged us to let her lie down, even though she was lying down. Employing a practice I had used when my husband's spine tumors raged, I placed my hands on her back to let the warmth of human touch help her relax. When the order for morphine hit the EMR system, we monitored the clock for each three-hour interval. Her children seemed to exhale as their mother's pain retreated.

 

Leaving the unit at the end of the day, I prayed that the oncoming nurse would treat JB and her family with compassion and be attentive to her medication schedule.

 

My body melted into the car seat as the phone rang. Judging by the tone of my husband's voice, this was more than an "are you on your way home?" phone call. Haltingly, he explained that the lawn-care company had begun our spring cleanup. The dead tree had been cut down while he was out doing errands. He'd spoken with one of the workers, who hung his head when he realized what they had done.

 

I fumed on the drive home. As I flew west along 25A with the sun setting on the horizon ahead, my anger gave way to sadness-for my robin, for my patient, for my husband. I pulled into the driveway. The shadow of our sentinel tree was gone and with it our robin, her nest, and her eggs.

 

I sat on the stoop and sobbed.