Abstract
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Tom, her husband, a tall, toned, and hardened man with a physical stature that was intimidating, was angry, lashing out at anyone who dared come within range of his voice. Anger, it seemed, was his only form of control in a life that had suddenly become so very out of control.
I had been consulted to discuss goals of care and resuscitative status, as Donna had neither an advance directive nor a living will, and Tom was requesting aggressive treatment despite a dismal prognosis.
I hesitantly entered her room. He walked up to me, his eyes pinched narrow, his right hand folded into a fist. He was so close there was still a wetness to his breath.
“If she dies…..y'all will wish ya never knew me.”
I backed toward the door.
He threw his arms up in the air. “How you expect her ta sing?”
I let the question linger, unanswered. I knew Donna was a singer with a local retro-60s country rock band, but I wasn't worried about her singing, I was worried about her living. I also knew the question was a veiled plea for hope.
“Has the surgeon been by?” I asked.
His face puckered with anger, as ropes of saliva hung from his lips. “No, but he better watch hisself, ‘cause I'm one angry pissed-off man.” He paused. “I got a cabinet full of huntin’ guns.”
“Tom, the surgeon did the best he could, Donna…..”
He walked up to me and pushed me in the chest. I fell backward, then reached for a chair to sit down. I measured the distance to the door.
He tightened both hands into fists. He was so enraged, his speech was arrhythmic and unfinished.
“You……better….sit………..down….before…..”
A brawny male nurse entered the room as a hospital security guard stood outside the door.
“Everything okay?”
“Yes, I think so.” The nurse looked at me, I nodded.
“It's okay.”
Tom collapsed in a reclining chair and began to cry, his anger seemingly spent. I sat there and waited. After 10 minutes of stillness, save the beeping of the heart monitor and the whooshing of the ventilator, he spoke.
“Doc, she was the best woman.” He realized he had used the past tense and corrected himself. “Is the best woman.”
He stood and walked to the window as scraps of sunlight filtered through the December cold. “We ain't got no family. Only had one boy, he died in a car wreck 10 years ago—the heartache damn near killed us both. Ain't got no livin' brothers or sisters either. Just me and her.” He wiped his eyes. “She's been my right hand; she's done everything, cooked, paid the bills, done the laundry, everything. What am I goin' ta do?” His voice trailed off. He stared at the floor. “She can't die, she's all I got.”
He sat silent for a few moments. “The surgeon told me the cancer looked like wildflowers bloomin' in her belly on the CAT scan. He didn't want to do surgery, but I told him no way, do what it takes ta save her.” He paused. “But I didn't know it was going to turn out like this.”
He rubbed his hands together, picked at his nails, and twirled his wedding band around and around on his finger. “Next week, on the 22nd, we'll be married 45 years.” He stared out the window, as if reliving the past.
I spotted nurses scurrying about out of the corner of my eye. A resuscitation cart had been moved to Donna's door. I glanced at the monitor, and noticed a brief run of ventricular tachycardia. Then another. The monitor beeped a momentary warning. Tom looked up. “What's that mean?”
“Let's step outside for a min…” Before I could finish the sentence, Donna was in ventricular fibrillation, and the cart, and five people, rushed in and surrounded her bed.
“Get him out of here!” someone yelled.
“I ain't leavin' her,” Tom said. “Do whatcha' gotta do, but I ain't leavin'.”
“”Stand back everyone…all clear? Okay, shock her.” The thud of the shock echoed through the room as Donna's body lurched in a spasm-like dance. “She's still in v fib, shock her again.” Donna's husband stood frozen, his eyes far away, his body jerking with each shock.
The surgeon came running into the room. I worried about a confrontation; instead, Donna's husband nodded to him.
After 30 minutes, the code was called. The ventilator breathed, the needles stabbed, the fluids flowed, the hands pushed, and the pads shocked, but the heart rested.
After the room was washed of the bloody debris of resuscitation, and Donna made to look like she was simply sleeping, I stood in a corner as the chaplain prayed. Then, as Tom stared at the floor with tear-filled eyes and trembling hands, he asked questions: “If the diagnosis had been made sooner, could she have lived? Why didn't the chemotherapy work? Why didn't the surgery work? Do you think she woulda' lived longer if she didn't have the surgery? Should she have gone to another medical center for a second opinion?” The surgeon answered the best that he could.
Tom's eyes scanned the room. “I'm gonna miss her, but I thank y'all for doin' what you could.”
We all stood there in silence. Tom collected family photos he had taped to the walls, hugged me, the surgeon, and the nurses, and kissed Donna on the forehead and said, “I'll see ya soon sweetheart.” He grabbed my arm and pulled me close. “Please tell them to treat her with respect in the morgue, she at least deserves that.” Then he disappeared down the hall.
I never heard from Tom again, for the memories were probably too painful for him to call, but I was told by his primary care physician that he was grieving horribly and had refused offers of help.
Then, one day some 10 months later, I received a call that Tom, overwhelmed with Donna's death, had gone into the bathroom at his house, jerry-rigged a rope to the trigger of one of his hunting rifles, put the barrel in his mouth, and pulled the trigger.