pronouncement

I didn't know the heart I couldn't hear was purple. When I put my stethoscope on his chest and pulled my fingers back so as not to mistake my own pulse for his, I heard nothing. It was the quietest I'd ever experienced with a stethoscope, no big vacuous lung sounds, no gurgling alien bowel sounds, no tick-tock-thump-thump heart sounds. Silent. I knew the heart inside had stopped. But I didn't know it was purple until I read the obituary a few days later.

*

"I got the call!" I shouted to my husband, who was perched on the edge of our daughter's canopy bed for bedtime books. "I'll be back in a little while."

I pulled on my scrubs, grabbed my nursing bag, and ran out the door. The on-call nurse had promised she'd let me know if anyone died so I could go with her to pronounce, a skill that I had yet to learn but desperately needed to, now that I was done with orientation and officially out on my own as a hospice nurse. 

"Have you seen a dead body before?" she asked.

"No," I said, not counting the garishly made up people I'd seen in open caskets. Those never seemed real to me. When I stepped into the room, I inhaled sharply, briefly stunned by the reality of seeing the man in his bed. But the feeling passed. He looked similar to a lot of my patients who are nearing the end of their lives--unresponsive, eyes closed, mouth open. It wasn't a cartoonish cadaver from a TV show, it was a man who was no longer alive, and we were there to care for him one last time.

*

He had an entire life. Survived by children, grandchildren, great-grandchildren. Preceded in death by a wife, a daughter, a grandson, several brothers and sisters. He'd fought in World War II. He'd earned a purple heart.

I read the obituary several times, and each time I forgot everything I'd just read except for the part about the purple heart. I'd listened to that heart, I kept thinking. It was silent. But it wasn't always so. It had been loud, strong, racing with adrenaline. It had been alive. 

*

We cleaned him up, the nurse showing me how to make the limbs a little more flexible as they had already started stiffening. We changed him into a clean shirt and pajama pants and pulled his sheet and blanket up to his chest, as if we were tucking him in for the night. The other nurse called the funeral home, the pharmacy, the medical equipment company, and the man's son--did he want us to remove the two wedding bands from his fingers, his and his wife's? He didn't need to decide right them. 

A man from the funeral home came, in a dress shirt and tie. He stood beside the man, made the sign of the cross, and then with help from the other nurse, slid him onto a stretcher, secured two seat belt-like straps around him, and draped a black cover over him. Later, I would tell my husband it looked like the cover we use for our grill. 

We destroyed the medications, grabbed the unused supplies to bring back to the office, and left the empty apartment. 

I'd not known this man at all but I was there, with his lifeless body and his silent purple heart. And then he was gone. 

*

It's hard to explain to people why my job isn't sad. Or why I love it, for that matter. "They're dying anyway," I try to explain. "That part is happening, whether or not I'm there. So given the choice, I'd rather be a part of it."

The man's purple heart was going to stop. That was the simple reality. And once it stopped, it didn't make any difference to him who was in the room, but it made a difference to me. I wanted to be in that room. I wanted to help take care of him one last time, in this most human experience of caring for the dead. I was there for the last moments of this man's existence in his apartment, before he was wheeled away to be tended to by another team, one whose job it is to try and reverse time, deny reality, and present a version of the person suitable for an open casket.

But I wanted to sit in the reality. The skin as it was, starting to cool. The mouth, open and yet not breathing. The chest still. The human body, the shell, discarded by the human spirit. 

To be there with it was beautiful, chilling in its power to remind me of just how alive I am.