1. Wilson, Marian RN

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Jerry died this week. I wasn't surprised. The last time I saw him he was sitting on his bed, cross-legged and skinny.


"Try to lie back," I said, my hand on his frail chest. He couldn't. The cramps in his belly forced him to lean forward, clutching his hot water bottle like it was his only friend. "If I could just get rid of this indigestion," he said. Antacids, laxatives, narcotics-we'd tried them all. Several doses of morphine and he was still awake, his eyes alert and pleading. When my dog Elvis gave me that look, I could figure out what to do. Get him his ball, open the door. With Jerry I had no answers. His pain was still there.


"The problem is that the tumors are pressing against your stomach," I explained. "There's nothing we can do about that. But I can bring some medicine to help you sleep. At least then you won't notice it as much."


"I'd like that. I'd really like to sleep."


As I turned my back he said, "Thank you." Jerry always thanked me, even for the smallest gestures.


As I drew up the Ativan and mixed the thick, oily substance with saline, I wished I had time to sit and wait for Jerry to fall asleep. If only he had some company, I thought, it might keep his mind off the pain, off the fact that he was dying. But no one came.


"Call if you need anything," I said, but I didn't expect him to. He would sit alone in the dark, wide awake, for hours. He never called for help.


When I checked on him later, the sedative had taken effect. Jerry's eyes were half-closed and rolled back into his head. He was still sitting cross-legged, his head bobbed to the left, dangerously close to the metal side rails. I slipped two large pillows in front of his chest, giving his head a place to rest.


Before my shift was over, I peeked in and saw that his pillowcases were covered with dark, green bile. He barely moved while I changed his gown and linens. As I washed his face, he opened his eyes and asked, "You're still here? What time is it?" His head dropped back onto the pillows, resting on his arms like a child's after recess. He fell asleep before I could answer.


I knew a few things about Jerry. I'd been assigned to care for him several times in his last few months of life. He was a high school guidance counselor and writer. He told me once, "I always thought if I could just get my book finished, that would really be something. But here it is, back from the publisher, just needs some rewrites before they print it, and I don't even care. It doesn't matter anymore. You know?"


I didn't, really, but I nodded.


"All I really want is to be here for my kids. Watch them play basketball. I want to be able to mow the lawn so my wife doesn't have to. She works too hard." I knew how difficult it was for families dealing with cancer. Still, I wondered why there wasn't more activity in Jerry's room.


I was with Jerry the day the surgeon told him the results of his CT scan. He could operate, but it wouldn't help. The doctor said he was sorry and left the room. Jerry stared at me. Two dark eyes, watching me.


"I knew there was nothing they could do," he finally said. "I know I'm dying."


"I'm sorry," I said, letting the silence give him permission to speak. He said nothing.


"Is there anything I can do for you? Get for you?" I asked.


"I'm fine," he said, looking away. I hated leaving him alone to digest this news. I wanted his family there to hug him and tell him he was loved.


I read about Jerry's death on the front page of the metro section. It wasn't an obituary. It was a news item, a statement of fact. He died after a two-year battle with cancer. He was due to stand trial the following week. FIGURE

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I hadn't known he was that counselor, the one who was facing charges for molesting a 14-year-old girl. According to the paper, many of their conversations had revolved around his illness. I remembered reading about the incident months ago and picturing the type of person who would do that sort of thing. Reading about his death, I realized just how little I knew of the patients who entrust me with their lives. They are mysteries, revealing only what they please.


I wish I'd known. It would have given me some insight into why he'd had few visitors, why his wife's visits had seemed so forced and brief. I could have probed his somber disposition, listening for clues as to why he'd violated this boundary. Was it the pain medication? The chemotherapy loosening connections in his brain? Or was it that he knew he was dying and figured he had nothing to lose?


I thought about his wife and kids, their embarrassment, the young student and her shame. It didn't seem fair that Jerry didn't get his trial. He would be guilty in the minds of those who never heard his side.


Jerry had a slow, miserable death. I never saw him smile.


I think often of his pleading eyes, and think I know now what they were asking. It wasn't only for the pain to cease, the bowels to relax, or the Maalox to kick in. I think it was for forgiveness, understanding, and some peace. I wish I could have given that to him.