Sunday, November 4, 2007

Pronunciation

It's daylight savings time. I know this because I showed up at work at 6am in the morning. After5 hours of sleep. I realized what I'd done when I walked into an empty break room. I sort of wondered why no one was coming in the building and why the parking garage was so empty--but, you know, too tired to really process it. Mark found this hilarious.
"Did you have sex last night?" He asks me.
"Yes."
"Well, at least you got to have sex..."
"It's not all it's cracked up to be."
Mark recently got a divorce. A spectactularly ugly one. "all the people I have sex with are psychos."
"Having sex makes women psycho."
"Is that it?"
I did have sex last night. Nice sex, surprise sex. But still....Jay has his this ex--the one who married the salsa dancer. And she called at 10:30 to ask how he was feeling (he has a cold). She has a little trouble with boundaries. She also dressed up as Marilyn Monroe on Halloween, plunging halter dress and all. Fortunately, she didn't shave her armpits and she has a lot of sun damage on her cleavage, so the effect was a little off putting. But you know, call me crazy, my hours are precious and I don't want to spend them on the ex.
So I started off grumpy. And got worse.
"What's wrong with you?" Wiz asks. "You're a little off your game."
We're short nurses again. Wiz is clerking, a thankless, horrid job, and charging as well. Sometime in the afternoon, he says, "Barbara's patient just passed, would you take care of it? She doesn't know what to do."
Barbara is one of our new travelers. Originally from Brooklyn Good hearted but oh so slow. And a little bit dense. A kind, lumbering woman with red curls piled on top of her head. I find her sitting in the conference room with the family of the patient. Everyone's crying. Barbara is talking about when her grandmother died, and how much her grandmother is exactly like their grandmother. Being southerners, the family is nodding politely, dabbing at their eyes. I sit, trying to find a place to interrupt and swing the conversation to the necessary arrangements to be made, but Barbara's monologue keeps blooming like kudzu. So I finally just hack on in. "Do you have her belongings?" Yes, they do. Barbara starts in again. They rehash the death in detail. Little by little I coax the name of the funeral home from them. finally, our business is done. They stand and leave, hugs all around.
"Okay," I say to Barbara. "Now, this is what we have to go through. This is the 'Death Checklist."
"Okay."
"This top part is filled out by the physician. What time was she pronounced?"
"1214."
"I can't believe he didn't fill any of this out," I say, scanning it, irritated. Doctors!
"Oh, that's probably because I pronounced her."
"You what?"
"I pronounced."
"You mean the Doctor doesn't know she's dead?"
"No. Well, I don't think so. I mentioned it to one of the doctors in the hall, but all he said was 'oh yes, she was very sick'"
"Which doctor?"
"Oh," Barbara scratches her ear with her pen, as if she is trying to dig ear wax out. "the one with the glasses. The Indian one."
This description fits about 25 doctors on our staff.
"Did he come look at the patient?"
"No."
"Huh." I say 'huh'because I really want to keep it together for Barbara and I don't want to make her feel bad, but this is really a cluster.
"So no one officially pronounced...."I say pleasantly, musingly...
"Well, I mean, she's dead. She's really very dead."
"Huh. Okay. " I say brightly. "Well, let's go tell the resident."
So we do. We have a new resident. Fortunately, he is about 50 years old and has spent a lot of his time doing something else, so he's fairly mellow and has some perspective on life.
"Mrs. Gore died." I tell him.
Deaths are usually busy affairs on our floor.
"What?"
"I just found out myself."
"We just turned around," Barbara offers. "We were all in the room talking and we turned around and she was dead."
"were you there?" he asks me.
"No."
"When did this happen?"
"An hour ago."
"Okay," he says, standing up. "I'll go look at the patient and speak with the family."
"They've left." I tell him.
"Who talked to the family?"
"Barbara and myself."
"What?"
"Just go pronounce, please."
"Jesus."
He goes into the room. "Yes, she's dead all right. Christ. Okay. Patient deceased at 1320."
Barbara says: "1215."
"I pronounce."
"But she died at 1215."
"Barbara, the shrouds are in the supply room by the refrigerator--could you please go get one?"
Barbara lumbers off.
"I'm so sorry. She's very good hearted, but she's not familiar with our protocol. It never occurred to me you had not been told."
"News to me."
We look at the woman. 95. A heart attack. Lived alone.
What do you do?
Wiz bought me coffee.
I'm exhausted. Barbara jumped ship, pretty much. Couldn't deal with the nuts and bolts. Death is so strange, it's so hard to touch people who have died, cleaning them up, turning them, realizing that everything you do is for the living--all the learned gentleness, all the small things that go into caring for the fragile, holding their skin so the tape doesn't rip it, supporting hips and shoulders. I admitted this woman the day before. I cleaned her teeth and held her hand. I washed her hair. I'm glad I took the time to do that. She wasn't conscious, but she would come to and clutch, afraid. It didn't matter now. But it still felt like it did matter. Zipping up the shroud. Leaves me empty and cold. Tags on toes. Covering a face, the series of steps that transform people into things.
Ok. I'm going to have a glass of wine now and go to sleep.

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