She was 82 years old — sweet, frail, and maybe four feet eight inches tall.

She had many beloved children, grandchildren, and even a few great-grandchildren

They all grew up knowing that family was their core — their base, their home where love resided.

It was only a few days before Christmas, and Mrs. Mary entered our ICU.

COPD.

She lived with this for a long time. But this time, it crippled her. We gave her an O2 nasal cannula and small amounts of morphine IVP for comfort to help her breathe and relax.

The family gathered around, and while in ICU, they decided on a group session, which included her ICU physician, a nurse (me), and the respiratory therapist.

We discussed DNR, DNI, and “comfort care” measures.

And behind the tears that welled up in Mrs. Mary’s eyes, she spoke to all of us:

“I have lived a wonderful and fruitful life. My beloved husband passed away ten years ago. I still love him, and I still miss him.

I will miss you here on earth, but please know that my spirit will always be with you. I’m ready to be at peace with my maker and husband. I will be your guardian Angel and look after all of you.”

We all had tears in our eyes.

It was a defining moment.

This 82-year-old dear soul — cognizant, totally alert, and oriented — made her decision: No CPR. No crushing of her ribs. No ventilator.

Her wish was to be with her family and die in peace.

Her little five-year-old granddaughter walked up to her “memaw” and presented her with a Christmas present that she picked out herself.

Little Amelia had a music box with an angel on top. As Mrs. Mary wound up the music box, the music came softly: “The first noel, the angels did say …”

They hugged each other and promised to be with her the next Christmas morning.

That next day, Christmas morning, light snow filled the hospital canvas. It was a quiet day, a peaceful day.

Her grandchildren and great-grandchildren had just arrived to wish their “memaw” a Merry Christmas.

As they walked into her room, they noticed Mrs. Mary had her eyes closed.

Agonal breathing.

Mrs. Mary let out her last breath.

She died with a peaceful smile.

And in her lap, between her hands, she held to the final moment the Angel music box.

We all held hands and hugged each other in this tender moment.

It was Mrs. Mary’s first noel in heaven.

“The first noel the angels did say …”

And her family realized that she was an angel. Their forever angel was effortlessly singing with her husband now and surrounded by many other angels.

Debbie Moore-Black is a nurse who blogs at Do Not Resuscitate.