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It was a typical Friday night in the emergency department. The cardiac monitor shrieked, several phones jangled at the same time and the rescue squad radio began its annoying screech. A medical resident shouted in the ear of an elderly lady, trying to adjust her hearing aid to hone in to the sound of his voice. In the background, a small child began to wail while being restrained for stitches.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

Standing at the nurse's station, I felt bombarded by the cacophony of the equipment noise and the sounds of misery from most of the patients. After hearing report on my assigned patients, I realized I would not be spared from the stress and confusion of the busy night.


I began the initial assessment of my patients. Preliminary rounds revealed much of the same activity occurring in the rest of the unit. A family fight was in progress in one room, a confused, elderly man with a Foley catheter repeatedly asked for a urinal in another, while a panicky mother with a happy, playful baby expressed concern that the doctor had not yet been in the room. I took a deep breath, tried to relax and began mediating the fight, emphasizing the catheter concept and reassuring the mom, when the call bell came on for the room next door.


As I walked in, I saw a gaunt and obviously terminally-ill woman lying on the cot, with her husband at her side, holding her head and hand. The patient had been vomiting, and her husband was looking for a place to deposit the almost-full basin. After dealing with the basin, I looked more closely at the patient and her husband, Evelyn and Charles Brown. Despite her emaciated appearance, Evelyn had a perfectly-coifed hairstyle and brightly painted nails. Her eyes had light-blue eye shadow that perfectly complemented her eye color, and her husband was carefully applying pink lipstick to her cleaned mouth. Even though I could almost see her bones through her paper-thin skin, and her appearance should have been the last thing on her mind, her husband was quite concerned about getting her lipstick "just right," as he said.


When I complimented him on his make-up artistry, both of them smiled at me. He explained that his wife had been the neighborhood hair stylist, working out of her home for thirty-five years. Five years ago, she was forced to retire after learning she had ovarian cancer and had then started the inevitable round of chemotherapy, surgery and medication treatments. Charles had retired a year later to be with her and assist with her care.

Figure. They knew he... - Click to enlarge in new windowFigure. They knew her time was soon and wanted to be together as much as possible.

Charles and Evelyn talked of how they had coped over the years, at first taking walks together. As the illness progressed, Charles resorted to pushing Evelyn through the mall in a wheelchair, carefully holding her head erect, as she had lost the strength in her neck muscles. At this late stage in her illness, Evelyn was bedridden. The couple spent their days in front of their large picture window, watching the birds that frequented their bird feeders.


"My wife has always been the looker," Charles told me, "and she always had her hair, make-up and outfit just so. Since she became bedridden, each day I had to select an outfit, arrange a hairstyle and apply complementing make-up, nail color and lipstick."


"He wasn't good at it at first, but I taught him some tricks of the trade," she explained, while looking lovingly at her husband. Charles laughed and told me that he never would have guessed that he had cosmetology talent. Charles and Evelyn were trying to make the most of the precious few days Evelyn had left. They both told me that they knew her time was soon, and they wanted to be together as much as possible. As I left the room, I turned to see him assume the position he was in when I entered-holding her hand and head, both of them smiling, talking softly.


I visited with them off and on during the evening, selfishly sometimes, as I just wanted to get away from the noise and commotion. Their room seemed a quiet, safe and loving haven. As an orderly wheeled Evelyn to her room, I promised to get up to see her the next day. "Just to see what outfit and hairstyle Charles comes up with," I teased. They both laughed, and Charles told me that whatever it was, "She'll look like a knockout!!"


Evelyn died that night. I'm sure her husband was there, holding her hand and her head. I sent Charles a sympathy card, including a note with my observations of their love and respect for each other and how glad I had been to meet them. What I didn't tell him was how it had affected my nursing experience.


Most nights in the ED are loud, chaotic, confusing and frustrating. Many times I feel that I am running in place, not accomplishing anything. Patient situations can sometimes be overwhelming in their indignity and negativity. The Browns are an example of all that is positive in a negative situation. Love, respect, dignity and peace were present in that room that night. I wish I could take a piece of that home with me every night. I wish I could give that to every patient and family I encounter. I realize that even though I can't, Jesus can. He assures us, "Peace I leave with you; my peace I give to you. I do not give to you as the world gives. Do not let your hearts be troubled, and do not let them be afraid" (Jn 14: 27).