Caroline found herself considering death and humanity after nursing a patient at the end of her life
This week I cared for a dying lady and performed last offices for the first time in my three years of training. Since then, I’ve found myself reflecting on what I believe happens when a person dies.
When I was a child, there was a series called “Children’s Ward” on television. This was a fictional programme and I remember once a poorly child talking to her nurse about where we go when we die. The nurse replied that she didn’t know, but it must be a very nice place as nobody ever comes back. I remember thinking how right that sounded, and have never forgotten it over 20 years later.
During my training I have seen many patients approaching death, making me consider my own views about what happens next. I am not particularly defined by one religion; rather, I believe in spirituality and cannot believe that “this” ends just like that, no matter how much time we have spent living.
Human beings are social creatures, defined by many similar characteristics, but completely different at the same time. Those differences are expressed through experiences, through memories, and they are felt through emotion. Humans are not like the animal kingdom: we do not eat to survive or mate to create offspring. We taste; we love; we think; we feel and sense so many different things.
There are lots of names for the dying process; perhaps these are meant to make it more medical, more understandable. Labels stage death and categorise it.
After nursing this patient, I do not think dying can be categorised in any simple way. The lady was tired. She had recently lost her husband and had since slowly withdrawn from life. She wanted us to help her but did not know how. There was no pain or hunger, only exhaustion: a feeling of having “had enough”. Our presence helped comfort her but she died the following morning and I asked to perform last offices.
“Our presence helped comfort her but she died the following morning”
The first thing that struck me was how peaceful she looked: how comfortable, yet how empty of life she was.
Her eyes were calm, devoid of emotion, but strangely settling. We washed and talked to her, dressing her in a crisp nightie before finally wrapping her, and drawing the bedside curtains as she left our ward.
It still upsets me that some people do not get better. I know death is a fact of life but to acknowledge it, even as a nurse, is painful. I know it is inevitable, even when we get everything right, but I also think it is a time when it is vital that we do get everything right, because this is when it matters the most.
I see dying as the shutting down of our brains and bodies, like the literature suggests. But I also think it is a culmination of our experiences, our memories – sometimes a drifting between those and reality, until those recollections take over and people are drawn back into them forever. I cannot believe after seeing this lady before and after death that her energy, her emotions, and her life experiences died along with her body.
“The momentum of that life, I thought, cannot simply have ended, gone with her last breath”
Surely they have departed somewhere into the universe, even though we cannot see them. I still believe they are circulating – even if it is only to live on in the people she left behind.
We can never know until we get to that point, that place, and we will never be able to pass on that knowledge so it will always remain a mystery. Despite this, I would like to believe in the words of the television nurse from my childhood – “Mags” I think she was called – that the place is a nice place, and that this is the reason that people never come back.
Caroline Estrella is a third year adult branch student at Nottingham University