he Hospice Hospital-Where Patients Check In but they Never Check Out

I had just left Older Sister’s hospital room on Thursday, when the rain began to fall. The rain, symbolized change, as it did in all good novels, only this wasn’t a novel. You knew when that happened that things would never be the same. The rain wept from the clouds uncontrollably, almost like a foreshadowing of what was to come. I had spent several hours there on Thursday, knowing I would be unable to return until today, until I had a sitter for Dear Son.

Younger Sister and I had our plan. We’d meet at the hospital Sunday morning, spend time with Older Sister, then go and take care of business at her home and then return. Minutes before I left the hospital, Younger Sister called and said Older Sister was near the end. She spoke with the nurse who confirmed the lungs were filling with fluid and she predicted she would die in the next 24 to 48 hours. I had been reading the hospice brochure I received on Thursday and knew her time was limited. Of course, she stopped eating and drinking on Thursday so I knew that without water, time would be limited. I had forgotten that the rest of the world doesn’t have feeding tubes, like Dear Son, so there weren’t any fluids getting into her body and there wasn’t any way to prolong life. Of course, hospice isn’t about prolonging life, it’s about being “comfortable” which really means they give you enough pain meds so you don’t feel the agonizing death.

The Hospice Hospital is a busy place. The woman in the bed next to Older Sister died on Wednesday, so she was no longer there when I arrived on Thursday. I missed her grown children who had visited often. The place seemed rather quiet without them. Today, during my visit, the staff came by to close our door; it seems another patient expired across the hall and they were removing the body. I doubt I would manage very well in a job like that. It has to be rough to see all of your patients die, and that is what happens.

Older Sister was gasping for breath when I arrived. I glanced down at the urine bag, and noticed the lack thereof. Decreased urine was on of the many signs indicating the patient had just days or hours. “Fish out of water breathing” was the other one I remembered, which meant just minutes. I was somewhat worried she might die when I was there. On the one hand, I didn’t want her to die alone and on the other hand, well, I was afraid. I knew this was the end, I could feel death hanging over us like a heavy cloud. It was excruciating listening to her gasp for her breath. I was very uncomfortable wondering how long I could listen to this and feeling selfish for feeling that way when she could hardly breathe. Younger Sister and I talked to her, and she opened her eyes briefly. She tried hard to communicate with us and tried hard to open her eyes. They’d open briefly and I was amazed at her will under the circumstances. The breathing was rapid and rough. It was so different with adults. With Dear Son, I know his breathing like the back of my hand. I know he’s in trouble when the breathing is rapid, like one a second. I know when he’s working too hard and when he’s taking too long in between breaths. That happens some nights when he has more seizures. He’ll go a long time in between breaths, like 15 seconds or so. I’ll jump up and raise the bed up, as if to help him. Anything to make things easier. But with Sister, it’s harder. I don’t know what to expect or what is normal. We stayed for a while and then we left, to take care of some business at her home.

As I was driving home, I called the hospital to see how Sister was doing. I had planned on dropping some things off and returning after that. I asked for her nurse. After some fumbling around, they told me she wasn’t available, instead, she was in Sister’s room. I asked them to transfer the call and the call was dropped. When I called back, it was too late. Sister was dead. Younger Sister returned to the hospital at 2:32 p.m. and Older Sister died in her arms at 2:40 p.m., the exact time of my call. The nurse said she was waiting for Sister to return. I hung up the phone and continued driving down the interstate, the snow blowing hard against my windshield. Suddenly, it seemed a lot colder and my body went numb. I am going to miss you Big Sister. You were loved a lot.