The Vitale’s

November 6, 2009

Contributed by Fran Harmeyer, OT

She still kept his picture in her wallet. He was 15, working for the butcher around the corner. She was 13 when they met. She took a long look and said, “He’s the one, I’m gonna marry that one, he’s the most handsome boy I’ve ever seen!”. And that’s what happened.

I met them 65 years later in a nursing home. She showed me the picture and told me the story. He had had a devastating stroke.

He was paralyzed on one side, arm, trunk, leg. He was confused, his speech was out of the side of his mouth, but he recognized Vera and hung on her every word.

The first week of therapy was really tough. Walking was a kind of two-sided dragging with a therapist on each side of the walker. Stuffed into a throne of pillows he was able to sit upright in a recliner. Still, as the days went by, he was more alert, looking around, following visual and verbal cues. And he was more responsive to the love of his life, Vera, his partner, the mother of his children, the woman he had dedicated his life to. I couldn’t wait to see how they encouraged each other along during his recovery.

The second week he took a turn for the worse and lost his ability to swallow. He was choking on his own saliva. When people reach this point, they are not allowed to eat or drink by mouth because the risk of aspiration pneumonia is too high. Aspiration pneumonia means you inhale your saliva, food and liquids into your lungs because the muscle that closes off the food tube when you breathe is paralyzed. The doctors gave the family a choice, keep him alive with a stomach tube to keep his nutrition intact or offer comfort measures only. Comfort measures only is a medical phrase that means you are letting the person progress toward recovery or death without medical intervention. No extra breathing apparati, no tubes in the gut or the nose, no pumps, no prods. The family chose nature’s course and Vera calmly began her vigil at his bedside every day. “He was a good man, a good, good man.” She told me.

When you work in a nursing home, some clients and families just grab you and you find yourself head over heels before you know it. This couple got me. I was amazed, in awe really, of two people who generously accepted what the other was. She was still proud of that young, energetic ambitious boy she knew five- plus decades ago. You could see her fondness and loving admiration for the person she had seen succeed, fail, and otherwise hack a path through life. I wanted to know what they knew.

I hadn’t seen the couple in a few days, so I stopped by the room. Vera was sitting in a chair next to the bed down by the foot, watching her husband struggle for breath. He was restless and seemed uncomfortable. You could almost see him trying to get out of his own body. I walked over, said hello and stood by the bedside. I saw the shallow panting that means the systems are shutting down. I put my hand on his chest to calm him. His breathing slowed. He stopped thrashing and then… his breathing stopped. It didn’t resume. I waited. Did he just need that little energy boost to finally let go? I wasn’t sure I was ready to be part of that , but at the same time I was aware of being pulled inside a seemingly magical process. The energy of the spirit trying to leave such an anchored, hard-wired-to-survive organism seemed like such a wonderful thing and such a difficult thing. I was transported to some kind of spiritual office where my job was to collect the tears of a lifetime, to hold them in reverence and honor, so that Vito’s life force could move on unencumbered. I was dumbfounded by the privilege.

Move on where? It didn’t matter. What tears? I didn’t even know this person. I wasn’t really concerned. Somehow it was just my job to hold his lifetime of earthly concerns in some kind of energy bowl just long enough…Almost like holding your friend’s purse while she tries on clothes in the dressing room. It seemed so natural. At the same time, my procedural brain was switched to high. Should I call a nurse? He’s not breathing. People in a health care facility aren’t supposed to die. I should pull the emergency cord. I should probably be documenting something. I took my hand away. A minute later his chest heaved and he was breathing, slow and deep. His eyes opened. I took his hand. “Are you an angel?” he asked. Before I could modestly remind him that oh no, I’m just a… His wife, from across the bed, without missing a beat, without blinking an eye, simply said “oh…he thinks you’re me”. “Honey,” she said reaching toward him, “I’m right here.” I went back the next day to see what else I could learn about that long term magic between two people, but he was gone. I silently thanked them for the lesson and went to my next patient.

Frances Harmeyer OTR/L  writes little stories about the people she meets in the world of inpatient rehabilitation at skilled nursing facilities. She is currently completing a Master’s Degree in Geriatric Health and Wellness. As a rule and on a daily basis, she is amazed by the variety of human experience at the end of life and is a strong advocate for choice at any stage of life.

Contributions to the Kairos Network Blog are made by its members.  If you are interested in offering your stories and insights to this blog or joining the Kairos Network, please send me a note at jdenney@email.com.

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