To Touch the Dying
by Thalia Margalit
To most who entered the room, she was already a corpse, as her only signs of life were read by machines. When spoken to, she did not answer. When touched, she did not respond. She lay in bed, arms limply at her sides, as her lungs were inflated and deflated for her. She showed no signs of pain or discomfort, no signs of awareness, and no signs of hope for recovery. It was clear that she would die imminently. Their job at this stage was unfortunately done. The treatment plan was to administer the appropriate doses of morphine and brace for a swift death.
Cathy, an ICU nurse, entered the room with a different agenda. With a broad smile that the patient clearly could not see, she introduced herself. “Mrs. Margalit, my name is Cathy and I will be taking care of you this evening.” The introduction went unreturned. Cathy noticed immediately that the patient’s hands looked chapped. The hospital air was particularly dry. She darted to the supply room, as if to get something essential, and returned with a bottle of lotion in her hand. It almost seemed absurd. She had an entire wing full of patients in intensive care for recovery. Their IVs beeped urgently, nervous patients paged her requesting help, and her colleagues waited anxiously for assistance.
And yet she sat down to take care of a woman who was asking for nothing. Not only was she asking for nothing, but she was dying and unconscious. Cathy took each hand, each finger and slowly massaged them with lotion, as if they were her own. The patient’s hands rested softly on the sheets.
Cathy returned again later to check on the patient’s status. The oxygen levels were stable, the pulse was within the expected range, but the patient’s head was sweaty. With a basin of warm water on her lap and the patient’s head cradled in her hand, she washed her neck and head. She worked like an artist; every stroke mattered as she gracefully cleaned around protruding tumors that might have been painful.
By the second day of their relationship, Cathy felt that she was now on a first-name basis with the patient. “Batya,” she began addressing her, “I’m going to move you a little so that you don’t get any sores.” She explained her work with a gentle voice to ease the anxiety that the patient might have been silently coping with. As if comforting a tired friend, she softly raised Batya’s side to prevent the sores that she knew this patient would probably never feel.
Cathy got to know her patient, not through conversation in words, but through the wrinkles in this woman’s hands. It was through this unconventional, intimate dialogue that she noticed that Batya must have held her children often, she must have chopped many vegetables, she must have worked hard. She looked into her soft eyes and saw a
sensitive person behind them. Most importantly, she felt warm blood; she felt a woman who was still alive. And so her duty continued—she spent little time reviewing the stats, and most of her time looking over Batya, with a growing intuition for her particular needs, and finding ways to potentially make life a little more comfortable.
She was a unique force in that room, trodden by herds of medical professionals gravely passing through with their arms folded, shaking their heads in defeat. She recognized that her job was most crucial at this moment when her patient could not vocalize her own needs. Instead of accepting her patient’s imminent death as a pardon from caretaking, she undertook the challenge to ease unspoken fears and to comfort unexpressed pain. Unable to estimate the bounds of life, Cathy treated her patient as I imagine she treats all of her patients—vital and dying, young and old—with respect.
As I watched Cathy care for my mother through her death, I stood in awe of her approach to medical care. She developed a relationship with my mom — a dying, silent, unconscious—but still living, woman. She got to know her through her interpretive eyes and a discerning heart in order to learn how to ease her suffering. When others were too scared to meet their eyes with death, Cathy embraced her privilege in holding a woman’s hand through her final course in life. With respect in her voice, hope in her smile, and comfort in her touch, she truly cared for my dying mother as the living human being that she was.
This essay was the first-place winner in the 2003 Arnold P. Gold Foundation Humanism in Medicine Essay Contest. Thalia Margalit was a first-year student at the UMDNJ-Robert Wood Johnson Medical School.