She was sweet, sad, lonely and...

She was ALONE...

It was just after midnight and things had finally begun to slow in the ER. We still had a near full house with only one fast track bed and one chest pain bed remaining available at the moment. (Fast track beds are used for people who can be “fixed” and released pretty quickly, so those beds are patients who go in and out in less time than others. Of course there are some cases that fool us at first glance. When they turn out to be more involved it usually necessitates us moving them to another bed for extended care).

This sweet elderly lady walked through the doors, escorted by a nurse. She looked frail and walked slow while refusing a wheelchair. As she pulled her head up to see where she was going, she saw me and tried very hard to muster a smile. She wore a pink and pale yellow print dress that was cinched at the waist with a gold belt. Her shoes were sensible ones with flat heels and a strap to hold them in place. I guessed her age to be late seventies and I wondered what was going on with her. She touched my heart at that moment as I could see her misery and hoped it would be resolved soon.

Dr. M went in to check her out and stayed longer than usual. He ordered a whole gamut of tests and I was inputting them for him when I looked up to see her lying there. She looked weary and she looked so tired. Something about her held onto my heart with such a grip I had difficulty thinking of anything else.

Minutes later she asked me for something to drink, her preference was sweet tea and I advised her that patients cannot have food or drinks until their lab work is back. She nodded as though she knew the answer and her look was one of total hopelessness. About that time, Dr. M came passed and I asked him (just in case she could be an exception to the rule). His answer was no, nothing by mouth (NPO is the term), until we get some lab results back. We were close enough to her bed that she heard the conversation and I caught a view of her as she nodded in acknowledgement of my effort.

I had a sippy cup on my desk, full of diet coke but I slid it over out of sight and even though I was very thirsty, I would not drink in front of this precious person who could not have a drink herself.

This patient’s name was Elizabeth and I still remember glimpsing at her as she lay there, so worried, so thirsty and scared. I wanted to hug her but I knew that would not really be appropriate so I turned back to my work at hand.

The faded out old hospital gown she now wore, did not hold a candle to that dress she had on moments earlier. I remember hoping everything would come out fine and she would be back in that dress shortly and headed home. Yet I knew in my gut that would not happen.

The results came back slowly and some of her numbers were so out of whack that the lab called them in as critical. I advised Dr M as I received them. He had sent her for a CT scan  with a request that it be read by a radiologist asap. It seemed like forever, but now the radiologist on duty was on the line waiting to discuss the results. It turns out there was a large mass in her chest cavity which also involved part of her left lung.

It appeared that Dr. M hesitated as he headed into her room, maybe with a feeling of dread with the news he had to deliver. He came out looking even more burdened and I could see Elizabeth as the tears flowed. It was a near certainty that she had cancer and Dr. M felt sure it had spread. She would be admitted to the hospital and more test would be ordered plus the on-call oncologist was called.

I caught up on my work and I went to her bedside. I took hold of her hand and just held it without speaking a word. She squeezed my hand and held on tight; then she began to speak of her life.

She told me "I had loving, devoted parents who gave me a life right out of a storybook"

She had never married and she had no children. Elizabeth was an only child, and had only one distant cousin from one of her father’s siblings and he lived out of town. She had no one except a couple of co-worker friends and did not want to disturb them this time of night, if at all.

She was 83 years old and still working full time as a secretary at a construction company in town. She was very faithful to her job, it was really all she knew and all she had to cling to these days. When she realized that she would be admitted, her only concern was that payroll had to be done the next morning and she could not miss work.

Dr. M. assured her that someone would do that in her absence and that she absolutely could not make it to work. 

The next day when I got to work, I checked with the secretary on her floor to see how she was doing. She had signed a DNR sheet (which means Do Not Resusitate).  I had planned to  find a moment to check on her, but by the time it slowed down in the ER, and I tip-toed to the door of her room, she was sound asleep. The next day, I checked with the secretary again on the floor where Elizabeth had been admitted, she said "she is resting right now". I learned that she was being discharged to a hospice across the street from our hospital. I decided I would visit her there the next day on my way in to work.

The following day, I was so excited that I almost skipped as I headed in the door. I walked into the hospice at 5:00pm about an hour before I had to be at work across the street. It was like the wind had been knocked out of me when I was told that she passed away early that morning. They told me her only visitor and only contact number was her boss and he had been notified.

I sometimes think about Elizabeth. There is no way for me to imagine being in her shoes. I have almost too much family, if that is possible. It sure made me stop and realize how very wonderful it is to know there are people walking this earth that share my bloodline and have an automatic feeling of connection. To walk in Elizabeth’s world was to walk in such a lonely, scary place with no safety net and no soft place to fall.

I get a chill just thinking about how that must feel.