March 14 2009

I wish Mike would be writing this instead. But he is busy writing letters to all the people who looked after him through the years. He is running out of time. The machine that pumps the blood around his body can stop any minute now, Mike is living on a borrowed time. There is so much to do, books to read, people to see, economic meltdowns to live through. But Mike is spending most of his time in front of his old Mac placed on the bedside table in his hospital room next to the LVAD console. LVAD, for Left Ventricular Assistance Device, is a pump placed four years ago in Mike’s abdomen to help his sick heart circulate the blood to his organs. Connected through an inch thick line coming out of the left side of his abdomen connected to an external battery and a monitor it’s designed as a temporary solution to buy time until Mike can get a heart transplant. Four years later, Mike has had the devise longer than any one ever had. He is not eligible for a transplant. He couldn’t lose weight. To be a transplant candidate he had to lose weight, he tried, but couldn’t do it.

LVAD, designed to work well for about a year, is “red alarming” frequently, it can fail any minute. There is nothing that can be done. Mike would not have survived a re-implantation of another device. All we can do is wait. I go into his room to check on him regularly. Most of the time he is in good spirits, we chat about weather, politics, families, tech articles. I don’t bring up the topic, I just wait for him to want to talk about it. He says he has to go to a vet today. His worried sister agreed to take him out on a day pass so he can be there when his loyal feline friend of fifteen years is put to sleep. What a timing! Mike cries a little, I struggle not to. He tells me how Missy used to climb up onto his desk and pat him gently on the shoulder to remind him it’s time to go bed when he lingered late into night in front of his Mac.

I leave Mike’s room to check on my other patients. One of them is 82-year-old Ms. Grinberg. Her coronary bypass surgery went very well and she is soon to be discharged to a rehab hospital. She is very appreciative of our work. There is a five-digit number tattooed on her left forearm, she tells me one of the young nurses asked her if that was her phone number. I don’t know how to respond. I just look at her. But she doesn’t appear to be upset, she asks though, “Don’t they teach about Holocaust in school?” I don’t know, I went to school in former Soviet Union, but it reminds me that Mike is converting to Judaism.

Before the end of the shift another nurse and I help Mike to take a shower-his first in four years. While not impossible, it’s unnerving to let water run over your body with an electrical pump in your abdominal cavity connected to a battery pack outside strapped to your shoulder. But under the circumstance Mike is not worried. Shower lifts his spirit. We joke and laugh, that he looks like a piece of luggage wrapped in plastic, as we cover open wound areas on his abdomen with saran wrap. It’s hard to believe he can be gone any day, any minute, he looks so good.

I come back to work Wednesday, look on the board, Mike’s name is not there. I hold my breath. Oh, wait, he was just moved to another room. I am not his nurse today, but I go in to say “hi”. Many family members are there with him, everybody chatting and laughing as if nothing is really going on, but the pump sounds loud and ominous, each thump exasperated by the worn mechanisms. Mike makes time to have a word with everybody who comes to see him: nurses, nurse practitioners, doctors-many people who have been working with him through the years.

Thursday afternoon we can’t get the pump out of the “Fail Safe” mode for over two hours. Our manager went to a liquor store to get Mike’s favorite Glenfiddich scotch. He is having a drink and cracking jokes. The LVAD is turned off by the team, there is no use in letting it work any longer. We don’t know how long his own heart can pump the blood to keep him alive. Minutes, hours? Mike’s brother-in-law gets an e-mail from Israel, the message says that Mike is now Jewish. I can barely hear Mike saying “Shma Israel”, he was ready. Minutes later Mike is dead. He looks peaceful, content. Bye Mike.

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Comments from Our Readers

  "Wow...you are an brave human being...doing the work of angels..." - Beth, April 21 2009 - reply
  "I think it is wonderful you can write about these people. I hope it helps you to cope. That is what writing does for me. Nurses are definitely Angels on Earth. " - jesse_jean57, August 14 2010 - reply

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