Standing by

Today was a march, but I needed to spend the day tracking down and sealing off drafts because the temperatures are supposed to drop into the teens tonight and stay very low most of the week. Before I started on that, I had to set everything up for a cold weather overnight at work – assign staff, notify the church, get the word out to clients. When the weather is below 20, one of our staff members opens the space at 8pm so that clients with nowhere to go don’t freeze to death on the street. It’s nothing fancy, sleeping bags on the floor, but it’s warm and safe and even our clients who will not stay anyplace else trust us enough to come inside for the night. I was just finishing up the overnight preparations when the Very Sick client’s uncle called. “We’ve decided to have them try extubating him,” he said, “and maybe lower the heart medicine.” I’m glad this is the direction they have chosen, but then he says, “we’re worried that his father might try to block this. If that happens, can you use your proxy to stop him?” I assure him I will. “Do you know Jeff, the volunteer?” I ask. “I love Jeff,” he says, surprising me with his enthusiasm. “I can have Jeff try to talk to him,” I offer, and the uncle agrees. I contact Jeff who tells me he was at the hospital with the father recently, and that he thought the father understood that his son is dying. He said he seemed mostly concerned about him agreeing to accept Jesus again and that he was happy when the client squeezed his hand in response to this. He also said the father was talking to the client about seeing him in heaven. He agrees to reach out just to make sure, and I let the uncle know that he thinks the father understands what’s going on. Later on, I get a call from his primary nurse. “I just wanted to let you know he is extubated and breathing on his own,” she says. “He is interacting with his family a little bit. If he starts having trouble we are not going to put the tube back, we will just give him medicine to make him comfortable.” “That sounds reasonable,” I say. “I’ll be on stand by in case I’m needed” – we both know that I mean in case my proxy is needed. I know the next call may well be the one telling me he’s gone and I’m considering that as I gather the laundry and fill the cats’ bowls. My mind wanders and I find myself thinking about deaths I was present for. I remember Bob Kohler’s last day, how he had gotten to the point where he could not swallow his pain meds and there was a delay getting the liquid that got to the point where I was thinking we might have to dissolve and inject the pills. Luckily a hospice nurse showed up with the liquid before it came to that. She gave him the meds, and Korn and Kara retreated into the back room, while I sat with him. He was dozing but restless so I put my arms around him, and told him “it’s OK, I’m here,” which seemed to calm him, and then he slipped away.