Navel-gazing from dissertation

This is my second doctoral dissertation. When I was writing the first, my brother died of leukemia. He died of pneumonia following a complication of his bone marrow transplant, and I sat by his side as he panicked, distressed and unable to breathe. I had no idea what I was supposed to be doing. Eventually we said a brief goodbye and he was intubated. I sat by his side, holding his hand and not knowing what to do, while the ventilator pumped air into his lungs until his heart stopped beating.

In the early stages of working toward my second doctorate, I had a chance to remediate that experience by being at my grandmother’s deathbed. She was always a difficult woman, but she had lost the ability to speak, and in many ways this made things easier for her caregivers. We knew it was serious and came when we heard she had punched the orderly in the face who was trying to feed her. I took turns with my mother, sitting by her bedside, as my grandmother, like my brother, was dying of pneumonia. This time, thankfully, there was no talk of adding a ventilator or heroic measures to keep her alive. After two weeks, it was a Sunday when she was evidently about to pass away. The nurse had ordered morphine, but in the UK a doctor had to be called from another hospital to sign for it (see http://painpersonalitypsychotherapy.blogspot.com/2009/03/worst-of-evils.html for a discussion of the power of doctors over the dispensation of opiates). My grandmother was evidently in a lot of pain, although she was unable to use her voice to communicate it, doubly silenced if Scarry is right about the difficulty of putting pain into language (http://painpersonalitypsychotherapy.blogspot.com/2009/03/body-in-pain.html). Finally, the doctor arrived, and I went to her, holding her hand and making eye-contact to comfort her, and said, “The doctor is here, he can give you something to help with the pain.” I tucked her blanket and went to close the door, so she would not overhear the doctor and my mother talking in the corridor outside. By the time I got back to the bed, my grandmother had lost consciousness and never regained it. The doctor examined her and the morphine was added to her drip while my mother and I continued to sit with her, prayer book ready. But it was the gentleness of that last caring communication with my grandmother which I felt transcended my ordinary experiences, in a way that informs my work with patients in pain.