This surprising request brought an emergency doctor to tears

Most of the time I feel as though I am running in quicksand attempting to bring patients to a place of grace and dignity in dying. On occasion, there is someone who jerks me out of my quicksand and plants me squarely on stable shore and then proceeds to show me what grace and dignity in the face of death really look and feel like.

Please meet Mr. Jefferson.

Mr. Jefferson had long, lacy eyelashes and puppy dog eyes. His smile was a mile wide. When I came into his room, he spoke first, welcoming me. I knew of course that this would be a unique experience.

“Hi Dr. Murphy, the nurse told me all about you,” he smiled.

“Well,” I quipped, “it’s either all lies or a paid endorsement,” and I reached out to shake his hand.

He reached out and gave me his wrist nub. There was no hand. I shook it without pause (emergency medicine prepares you to react normally in abnormal circumstances).

Continuing to attempt a “normal” patient encounter, I asked, “So what brings you in today?”

“Well, this for one,” he pulled back the covers to reveal his swollen, tense abdomen. He had the appearance of having swallowed a couple of basketballs and the veins of his belly were bright and distinct, criss-crossing like a Google map of winding highways.

“Oh, yes, I see,” raising my eyebrows a bit while noting in his chart that he has required paracenteses recently.

Before I could begin to question the reasons for his girth, he continued on, “And I need to see the hospice people.”

“You do?” I asked, rather shocked. I was no longer able to “act normal.”

“Yes, ma’am,” Mr. Jefferson replied. Then he said, “Doctor maybe you should sit down.”

I sat.

Mr. Jefferson proceeded to tell me his life story in a brief and touching vignette. He had married his high school sweetheart. They had a marvelous life together until he began to suffer the ravages of poorly controlled diabetes. Two legs lost and one hand amputation later he could no longer take her dancing. Then his kidneys and liver failed. Now he was on dialysis 3 times a week and had needles stuck into his belly on a regular basis to relieve his suffering.

“But now, I’m done. I’m ready to ‘go home’ and I need hospice to help my sweet wife to get ready for me dying,” he said as he reached out his wrist nub to pat my hand.

I responded just like any highly, trained professional would: I burst into tears.

He responded gently to me. “Oh no, really, don’t cry for me doctor. You see, I’m OK with this. I’m even looking forward to it, because when I get to heaven I’m going to do a Christian dance. I will have my hand back and I’ll be able to move my legs. Then, I am going to practice dancing till my wife comes to join me.”

I think I cried a little harder.

I attempted to straighten myself up but could not, so I reached out to hold his wrist nub and apologized. “Mr. Jefferson, I am so sorry that I’m crying but I have never met anyone like you. You see, I spend a lot of time talking to people about how to make dying peaceful, but you …”

“You don’t worry about me, doctor, I have perfect peace. Perfect peace.”

I was speechless.

Finally, I got myself together and we made a plan to draw more fluid off his belly and to call in the hospice nurse for intake evaluation.

As I turned to leave, I thanked him for giving me the honor of taking care of him. And then I said, “Mr. Jefferson, I will always remember you.”

Smiling, he said, “I will always remember you too.”

Monica Williams-Murphy is an emergency physician and author of It’s OK to Die.

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  • EmilyAnon

    What a touching and beautiful story. I hope I have the same grace when my time comes.

    • Suzi Q 38

      Wouldn’t that be nice?

  • Suzi Q 38

    Thank you for sharing your story.
    If I had such a difficult decade as he has had, I probably would be ready, too.

    We had a party for my FIL on his 82nd birthday, a month before he died.
    He saw all of his friends and family alive, before he died.

    He told us he was ready, even though he was aphasic, and could not carry on a regular “conversation.”

    After the party, he declined dialysis. We told him that without it, he would die soon. He said that it (dying) was “O.K.” with him.

    He told his doctor the same. The doctor did everything he could to make him comfortable without prolonging his life.

    He had had several heart attacks, a heart bypass, subsequent infections,
    bed sores, three major strokes, three tonic clonic seizures, and who know what else. He told me that 12 years of this was just too much, as he was in a wheelchair and he was tired of it all.

    He became a “frequent flyer” at the E.R. for about three weeks before he died. He was such a gentleman about it all, that the day he died, he waited until I left him to visit another relative at a different hospital before he died, as if he could just will it by command.

    The nurse said that she tried to give him a blood transfusion when he was “crashing.” She said she had to stop because he vehemently told her “No!” and held her arm, stopping her from proceeding. She said that she told him that without medical help that he would die, to which he responded: “That’s O.K…..”

    My husband would not put a DNR on him because he wanted him to be around us for a few more years. I am glad that he was in control of his medical care at the end, and that the nurse was able to tell me the story about him.

  • Ava Marie Wensko George

    Incredible story. Thank you so much for sharing it.

  • Elaine Mansfield

    Thank you for this exquisite, heart and eye-opening piece. I plan to share it on my FB page. I hope Mrs. Jefferson got the help she needed from Hospice. I’ve been in her shoes and am a bereavement volunteer now. Hospice helped me so much, especially after my husband’s death. You bring these issues into the open in a powerful nonthreatening way–here and in It’s OK to Die. Thanks again.