||[Oct. 31st, 2005|04:48 am]
She's never been in the ICU before. Her nurses seem flustered by an awake, alert, and somewhat imperious patient. I suppose that in the ICU you lose the habit of dealing with patients as people: all the others in intensive care are still as mummies, wrapped in bandages and tubing.
When I started writing this I was going to say that Marsha's in the ICU because her blood pressure was low. After googling, it looks like she has severe sepsis or possibly septic shock -- urinary tract infection, high temperature, high heart rate, very low blood pressure, altered mental state before they got her blood pressure up.
Mortality for severe sepsis is between 28 and 50 percent. The most dangerous period is the first three days, which have already passed. I don't think she'll die this time, but I think this is how she'll die. Presumably she hasn't had severe sepsis before, since she has never been in the ICU, but this year she's been in the hospital six or eight times, in retrospect all for sepsis. The mortality rate for common or garden variety sepsis is 15%, so she's been dodging the bullet for quite a while.
The ICU waiting room is almost never empty. There are little groups of people, often teary, often with the weary laughter that comes on the edges of grief. I avoid, it mostly, though it has a wireless network for my laptop (with the gruesome network name of "put2sleep"). I avoid it because I want to give the little groups privacy; and I avoid it because they remind me that I'm here alone.
I don't see visitors in the nursing home, not often. Two or three times Marsha's roommate has had visitors when I was there, two or three times in four years. We humans come through for each other in crises. That's why the stories of atrocities out of New Orleans during Katrina rang so false. We don't do so well in the long term, which is why the aftermath of Katrina is likely to be so grim.
I don't envy those little groups their friends' disasters. I'm glad Marsha is grumbling at nurses and sparring with chaplains instead of being a mummy. I'm glad she's survived so much, and that she's still herself. I have been able to talk by phone to some of the people I'd want with me in the little group in the waiting room, if there were a little group. That's very precious. And still I feel alone.
Marsha meets the chaplain
"Hi, I'm Tim McDermott, the chaplain here."
"Is there anything you need?"
"O.K. then. I'll be praying for you."
"And I'll pray for you."
"Good, I can use that." (With a professional chuckle.)
"Oh, what's going on with you?"
"Well, you know, we can all use..."
Marsha doesn't much like chaplains (too much like social workers, aside from the religious difference), but I'm sure her question was sincere. If Tim had told her about a moral dilemma or a troubled parishioner or his drug-using teenager, she'd have listened with a will. She takes no shit from anyone, she's blunt, she's not always reasonable; and if you tell her about your life, she'll hear you out.
The Angel of Death
There's a statue of the Angel of Death in the Philadelphia 30th train station, dedicated to the workers of the Pennsylvania Railroad who died in World War II. It's startlingly homoerotic, the angel and the half-clothed dead soldier in his arms. It probably couldn't be built today.
Last Sunday I prayed there, for Marsha to have as much life as she wants to live, and a good death, and for me, the opportunity and the strength to help her in those things. May her passing be easy, and her life up until the end be worth living.