Vietnam

 "I'm going back to Vietnam," I told my husband, pulling on my scrubs. I was referring to my new patient, a man I'd seen the day before and left his home feeling like I would never truly be able to explain what I'd seen or how I'd felt, and that nobody would really understand except the three of us in the house: the man, his wife, me. I don't pretend to know what it's like to be at war, but I do know what it feels like to have my senses overwhelmed, to be completely spent physically, emotionally, mentally...and then to hop back into the regular world of homework, dishes, birthday cards. Whiplash. Re-entry.

I knocked. His wife hugged me. "I'm so glad it's you again," she said. He was exactly as I'd left him the day before. Exhausted, in agony, puddles under his feet as his body filled with fluid that had nowhere else to go except to leak out through his skin. 

In nursing, we call this weeping. 

My mind was racing. What next? Where to start? He desperately needed to be cleaned, and yet his skin was so open and raw that everything was stinging, on fire. He desperately needed to sleep, and yet he couldn't get comfortable in the chair or the bed. He desperately needed to catch his breath, but his fear and pain and anxiety were taking over his ability to breathe slowly.

"We need to get you comfortable," I said. "Can I give you some morphine?"

"No! I don't want to get constipated. I don't want to get loopy."

I knelt in front of him. His eyes harrowed with fatigue, pain, fear. I felt helpless and inexperienced. But I had to take control. I swallowed and tried to make my voice sound authoritative. 

"My friend," I said. "You are in pain. I don't care about constipation. I don't care about loopy. The only thing I care about right now is your pain. We can't do anything else until we deal with the pain. Ok?"

He nodded, shaking, on the verge of tears. He gripped the edge of the bed tightly. Moving, sitting, standing, breathing--every action was a Promethean task for him. The cancer was winning by a long shot.

I gave him the morphine. 

While it settled in, we made a plan. He would need to stand so I could clean him. It would take time, and it would be painful. His legs would ache. His arms would shake as he leaned on his walker for support. My adrenaline would take over. You can do this. This man is in pain and he needs you to do this, so you will. 

Where would he go after? He refused the recliner. The chair. The bed.

"My friend," I said, using my newfound Voice. "You cannot stand here all day. You need to sleep. I would love it if we could try the bed again. Can we do that?"

He nodded, defeated, afraid.

I was sweating. Worried. Feeling so out of my depth of knowledge and experience but determined not to show it. They need you, my adrenaline kept pushing. Keep going.

He cried out as he sat back on the bed, his skin burning all over again, despite the cooling cream I'd applied. His wife and I each lifted a heavy, wet, leg, dense as rain-soaked firewood. Pads under his body. Pads under his legs. Pillows behind his back. The head of the bed adjusted so he could breathe. 

I wiped my brow. "You look good," I said, smiling. 

He shrugged, but didn't disagree. He was clean. He was calm. He could breathe. He could safely fall asleep in this position.

We balled up the soaked pads on the floor and threw them away. We adjusted the sheets over him. His wife arranged and rearranged a blanket. 

His wife and I went into the tiny kitchen, stepping over cat hair and the clutter that had accumulated while she was overwhelmed with her husband's care. The sink full of dishes. Laundry spilling out of a corner. We drew up syringes of morphine. I taught her how to crush the anti-anxiety medication and mix it with the morphine. I wrote out the schedule. "We have to stay on top of his pain," I emphasized. "Pain, anxiety, and shortness of breath travel as a pack--it doesn't matter who shows up first, the other two will come, too." She understood. She was desperate for him to feel comfortable. To sleep. 

*

The next morning, while on my way to see another patient, I got the news.

I let my husband know. Vietnam died.

*

I knew his wife must have been beside herself. My heart broke for her. And at the same time I felt relieved to know he was finally at peace. Proud that I'd been able to help him get even a little bit more comfortable before he died. That the voice kept urging me on until I saw him for the last time clean, calm, and comfortable.

The onslaught of emotions and reactions hit hard. Exhaustion. Sadness. Pride. Self-doubt. The details of the house, the sounds and smells and textures of each visit. The swirl and chaos of managing two people in a home who are unraveling and looking to you to put them back together. 

I couldn't do that, of course. By the time he was in my care, the pieces were too shattered. But I could soften the edges a bit. Make him believe that I cared deeply about his pain. Let him see that I wasn't going to leave him undone. 

Even describing it to my husband, to my sister, in my writing...it still feels like something that could never really be known. Except by my patient. And his grieving wife. And, by some blessing, or grace, or fortune...me.