March 7, 2014

Through a Monitor, Darkly

Monday is a blur in my mind. Visiting periods came and went in a four hour cycle, stretches of monotonous waiting punctuated by bouts of profound sadness. Another procedure was tried and failed. Meds were added and adjusted. A second night passed in the ICU without any significant change or improvement.

By Tuesday, there were no more procedures, no new medicines. The doctors told us that they would keep monitoring my dad for one more day, but the chances of any turnaround were slim and the chances of something failing — the kidneys, the heart — were great. The only thing left to do was to make him comfortable and to prepare for the inevitable.

Letting go isn’t easy, so it wasn’t until Tuesday evening that the family steeled itself and made the call. We stepped out of my dad’s room long enough for the nurses to remove the ventilator, and then we gathered around the bed and waited. What went on in that room during the next ninety minutes isn’t right for telling. Final moments are tragic and personal and not fit for public consumption, and I won’t detail them here.

What I will tell is the tale of a screen. It was a bright, modern touch screen mounted on a rolling cart to my dad’s right side. The screen had multicolored indicators  — heart rate, breathing rate, pulse, oxygen saturation — and numbers large enough to be read by a nurse across the room. It was a picture of my dad’s health, a story of what was going on inside, and in that final time I couldn’t stop watching it; because within that screen I could watch him slip away.

The numbers started fairly stable, but they soon began their final turn. Heart rate dropped first, but oxygen saturation and pulse soon followed. Breathing rate held out the longest. The progression wasn’t steady; there were fits and starts and backtracking. But the overall downward trend was hard to miss, and as it sped up the fits and starts went away.

Alerts began to appear: LOW BLOOD PRESSURE. SEVERE BRADYCARDIA.

The oxygen saturation dropped to zero, then spiked back up. Breathing rate began to increase. Heart rate began to fall fast. Lights blinked. Warnings flashed. Numbers plummeted. Oxygen dropped back to zero again. HYPOXIA, the screen warned. And then, ASYSTOLE.

After that, there was no point starting at the screen; there was nothing left to monitor. The numbers blurred and the warnings became unreadable as the tears welled up in my eyes. 

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