She had managed to stay at home for most of her illness, fighting hard and long and sacrificing physical comfort so she could be with her husband and their dog. "I'm not afraid of pain" she'd say "as long as I have Will and Boomer, I can manage anything".
The decision to move her to a hospital room was made after many days of pain so severe that I cannot even comprehend it. The PO medication our service physician had prescribed for her wasn't even touching the pain she had, and the constant nausea and vomiting were making what life she had left an utter misery. We talked at length about what being admitted would mean. "But the visiting hours are SO restrictive, my Will won't be able to come and see me whenever he wants. Boomer will be here alone and he'll think I've forgotten him". Tears pooled in the corners of her eyes "it's bad enough that I have to leave him; I can't bear him thinking that I've rejected him".
"Miss Ellie" I said " Will can come and be with you as much as he likes. He can even sleep there....I'll talk to the ward nurses and we'll make sure that he's given as much time with you as he wants. And, if any of them complains or gives you a hard time about it, I'll personally go whup their nursey butts".
She tried to giggle, but the giggle morphed into a grimace as another wave of pain washed over her now emaciated body. I think that's the hardest part of watching someone die - seeing the physical changes that happen as a disease process takes it's toll on them. I can't imagine how it must feel to actually BE in the body that's being ravaged.
She knew that we couldn't arrange for Boomer, their Australian shepherd/Collie cross to come stay at the hospital with her, so she said her goodbye to him before the ambulance service came to transport her. It was incredibly emotional and I cried unashamedly as I watched her run her hands through his fur for what she knew would be the last time. "Be a good boy for Will, now. Remember he doesn't speak woofer-ese, so you can't just stand in front of the fridge and bark, you have to find some other way to let him know you want some ice. I won't ever be very far away, Boo...I'll be waiting for you when you come across that rainbow bridge"
When the ambulance arrived I was relieved to see a familiar face in the passenger seat. "This is Johnny, Miss Ellie. I know him from EMT class and I know he's a really good guy. He'll look after you just fine" I met Johnny's glance across the stretcher. He had a smile pasted on his mouth, but his eyes told a different story....much like mine did, I suppose. "I'll meet you at the hospital, ok? I'll probably get there before you, so I'll go sort out your room and try to get things squared away the way you like them".
Will and I drove to the hospital in my car. He was younger than Miss Ellie, and I had always thought that they were somewhat of an odd couple: she was very well educated and liked to read classic literature, he had worked a menial job and, in his retirement, had developed a passion for game shows. He sat in the passenger seat silently, wringing his hands the entire 20 minute journey. As we were pulling into the hospital parking lot, he looked at me and said "this is it, isn't it NM? She aint comin' home, is she? I'm-a hafta say goodbye to my girl before too long here...."
I was quiet for a moment - I was trying to find the most appropriate words to tell this man that yes, this was the end for his wife and no, she probably wouldn't be coming home again. As eloquent and verbose as I usually am, this time my vocabulary failed me.
"I'm so sorry, Will. I don't think she'll be coming home again...."
" I failed her! I done let her down! She made me promise to make sure she died at home, and I can't make that happen! The one time she needed me, and I let her down....." and he started to sob.
The only thing I could think to do was to park the car and hold him as he cried.
After we got Miss Ellie situated and comfortable in her room (IV morphine, 20mgs/hr, IV Ativan and Zofran and an NG tube) I fetched Will from the family room. As we walked down the hallway to Ellie's room, I tried to explain to him what to expect.....but it felt as if, in that short space of time, he'd built a wall around himself. He was very quiet and very stoic and when we entered the room he barely even looked at her before going and sitting on the other bed, announcing that he was tired and would it be ok if he took a nap.
"Of course, Will. Is it ok if I stay and keep an eye on Miss Ellie?"
"Sure"...and he rolled over to face the wall.
Once she was comfortable, Miss Ellie went downhill very quickly. Within half an hour, she was unresponsive to verbal stimuli, and an hour after that she was scoring a 3 on the GCS and had pronounced Kussmaul respirations. I sat with her the whole time, holding her hand and stroking her hair. I thought that Will was still sleeping until I got up to stretch my legs and saw him laying on his side, watching his wife.
"I don't think it'll be much longer, Will. Do you want to come and sit with her?"
"No, I'm ok where I am."
Another two hours passed and Miss Ellie was doggedly hanging on. I'd asked Will a couple of times if he wanted to come and sit with her, and each time he'd refused. That man laid in the same position the whole two hours; it was as if he was frozen by grief. After some careful thought, I got up and went to sit next to him.
"Will, I think she's waiting for you"
"Sometimes when people are dying, they wait for folks. Some people want to die alone and will wait until everyone has left, other folks hold on and on until a certain person is there with them. I think that Miss Ellie is waiting for you.....she's been on the verge of letting go for hours now, and I just get this feeling that she's waiting for you. Y'all did everything together during life..."
He sighed, and tears began to curl down the bridge of his nose and plop onto the pillow.
"How can I do that, NM? How can I say goodbye to her? She doesn't even know I'm here"
"She DOES know, Will. There's no doubt in my mind that she can still hear....come sit on the bed with her and talk to her. She can hear you, trust me".
Wiping his eyes, he sat up and shuffled over to Ellie's bed. He stood there for a moment, swallowing hard and brushing away the tears that were still falling with the back of one work hardened hand. He looked over at me as if to say 'what do I do know?' so I got up and knelt down on the floor next to Ellie's pillow and took her hand.
"Miss Ellie, Will's here. Don't be afraid, sweet pea. Will's right here..."
I nodded at him, and he sat on her bed. I put her tiny white hand in his, and he kissed it
"I'm here, my love. I didn't leave you....I won't ever leave you. I love you, Ell. I love you so much.....but if you need to go, honey, then you go right ahead. Con te partiro, Ell. Time to say goodbye and go on home now... con te partiro, my darling"...and he kissed her hand again and clasped it to his cheek.
Not 10 seconds after he'd spoken, she died. She simply stopped breathing and her heart ceased to beat at the same time.
She was waiting for him. She needed him one last time.....
He played Andre Boccelli's 'Con Te Partiro' at her funeral.
I still see Will from time to time. I wondered about his ability to cope after she died; I thought that he might perhaps go into a decline and follow suit (I've seen it happen; one lady lost her husband of 63 years on a Thursday afternoon and died herself on the Sunday morning) but he surprised me. Our social workers followed up with him and arranged for him to go to a couple of social gatherings, and he took that ball and ran with it. He is, by all accounts, a regular social butterfly... he bowls and lunches and can be seen on any given morning walking Boomer in one of the local parks. I am not only happy for him, I'm also grateful to him for letting me be a part of he and his wife's life. I won't forget either of them.
(I miss you, Miss Ellie. Thank you for sharing a part of your life with me.)