Sorry

Every shift someone dies. I go home plagued by memories in sharp clarity that evoke my senses: the indescribable smell of death. The hum of a bumble bee as it slips into the sunny cup of a daffodil in the nursing home garden. The red, puffy, tear-stained face of a distressed colleague. A resident clapping and singing with no concept of what is going on inside and around them. The gravelled grating of Cheyne-stoking–the death rattle. The waxy mottling of skin as the body undergoes gas and chemical exchanges as it prepares to return to the earth. Ashes to ashes, dust to dust. Let the bodies pile up.

A resident’s daughter wants to be with her elderly, dying mother, a small bird of a women with twig-thick legs and skin as fragile as a dried autumn leaf. I already know what the answer is as I wait for the response from head office, but I need to try. The email arrives, I read it and take myself off to the treatment room where I can hide for a few minutes to try and make sense of what I am about to do.

It’s an unseasonably hot May, the window is open, and I welcome the light breeze that chills the sweat on the back of my neck. I pull over a chair and sit for a moment, pull down my mask, and breathe deeply, enjoying the fresh air.

It’s only been fifteen months since I said goodbye to my own mum for the last time, and I’m still raw with grief. I can’t help but put myself in this woman’s shoes. I don’t know what I would’ve done had someone denied me the right to sit with my mum, let her know that she was not alone, hold her hand and encourage her not to be afraid as she slipped away from this world.

Who am I to deny mother and daughter what I believe to be a fundamental right? The cold logic of it all filters through. I’m a nurse. I have to follow guidelines, policy, protocol. But this?

I look down at my navy blue tunic stained with explosions of runny hand sanitiser that are housed throughout the home like sticky, congealed ketchup bottles in a greasy spoon. My hands sting every time I use it and I stink of alcohol. I wonder how many virus particles rest on my uniform, if they perish when they hit the gloop, if they die quick or slow, peacefully or painfully. I’ve already had the virus, so, I have some immunity and I’m not frightened for my own health, I just want to do the best I can in this surreality.

I leave the room pulling my mask up. The back of my right ear begins to ache, and it occurs to me that this was bothering me earlier as I tried to get through the medication round amidst chaos and carers flitting from room to room, donning and doffing visors, googles, masks, gloves, aprons, trying their best. There’s no manager here, only a deputy, a young Irish girl with a few years’ experience. She’s gone into town to buy individual bins to place in the residents’ rooms for discarded and contaminated PPE. I wish that she’d make the phone call I’m about to make. I rub the back of my ear. In the compact office I sit at the desk, pick up the phone. A heaviness settles between my chest and stomach. The woman answers and I tell her that she is unable to sit with her mother and share her last moments with her before she’s gone forever. I tell her she is unable to comfort the woman, the constant presence that has been with the daughter her whole life. I hear myself tell her how sorry I am, my tone hollow and monotone, and I want to scream. But sorry is all I can say and I feel shamefully grateful for the phone, for the distance this creates. Grateful that I’m not in the same room with her, grateful that I don’t have to look her in the face, in the eyes and deny her her right.

I reassure her that I will do everything I can to keep her updated and tell her I’ll have to go as the “Haaaallloooooooooo! Haaaaalllooooooooo!” of an infected resident bellows out. He approaches the office door wearing only his pyjama top. I take his hand and lead him back towards his room. He is burning up and confused as I guide him to his door and encourage him to go in while I put on gloves, apron, goggles, mask, and visor. He’s distressed and wont let me help him. A carer comes in to tell me that the deputy is back with the bins, and she seems worried and tells me the resident won’t stay in his room. Between the two of us, we cajole the resident and encourage him to at least put on some underwear. He looks down at his indignity, puzzled, and sits on the bed, lifting his legs to allow us to pull on a pair of pyjamas while I reassure the carer that we can’t force him to stay in his room.

I leave and doff my goggles, mask, apron, gloves, put on a clean mask under my visor and look for the deputy at the back door where I find a collection of shiny planters, the tall slim ones that flare out at the top. The deputy smiles, and says in her lovely Irish lilt, “aren’t they pretty?” I hear myself say, “what the fuck are you playing at?” Her happy features dissolve and she defends her purchase, “I thought that at least we could get something that looked nice.” My heart thumps in my chest and when I open my mouth to speak I’m not sure what I’m going to say, but I don’t have to worry as we’re interrupted by a carer, hair plastered across her brow, who tells us that the resident with the twig-thick legs has passed away.

It is so hot as I make my way, alone, to the elderly woman’s room. I slowly donn the PPE: new mask, goggles, gloves, apron, trying to make sure I’m following the correct sequence. Sweat trickles down my neck, tickles my back before soaking into the waistband of my trousers. I enter the room where a stillness has settled that is more than just quiet. Life has taken its leave and left an emaciated husk. The mouth is open. The chest is still. The eyes stare lifelessly towards the window where a paper butterfly she made at a craft workshop hangs. I place two fingers on the cooling skin of the neck, over the carotid pulse. It’s still.

As I stand staring listlessly at the body, I lose myself in a flickering montage of memories of my mum’s last days as she nibbled midget gems in her hospital bed while she rallied. Her bowed head, flushed cheeks, face obscured by an oxygen mask–panting. Her voice was weak as she repeated my last sentiments to her “I love you with all my heart and soul too”. The morse code she squeezed into my hand: be strong, be brave. Running through the concourse at Ninewells Hospital with my sister and daughter, frightened birds returned to the nest one last time before she slipped away forever.

I’m sobbing, bent over the bed, forehead resting on my forearm, tears pooling in the safety goggles, snot dripping from my nose. I take off the goggles and shake them, grab a hand towel from the ensuite and wipe my nose. I touch the dead woman’s hand as if to reassure her as I leave the room to phone her daughter. I tell her I’m sorry as I close the door.

Back in the office, the phone rings out and I arrest the emotion as it rises from gut to chest, but as soon as I hear the daughter’s voice I choke up, trying to keep my own voice steady as I announce myself. I tell her I’m sorry to have to tell her that her mum slipped away peacefully a few minutes ago, and I hate myself for the lie. And I’m crying. The truth of the matter is that I don’t know if she was peaceful or not because she was alone when she died, the carers were busy with the residents who are still living and I was swearing at the deputy for coping in the only way she could. The chaos, what I imagine a military field hospital to be like, only without the bombs, the enemy here is stealthy, and we are all under attack.

The daughter thanks me for letting her know and there is no breaking of her voice, no stunned silence, no sobbing. I apologise for crying, but this is not a problem for her. She simply asks me for a favour, warns me her request may seem strange. She wants me to Skype on the home iPad, she wants me to take her to see her mother for the last time.

Relief floods through me as I process the request. This is the absolute least I can do. We make the arrangements and I find the iPad and climb the stairs, finally feeling that I am doing some good. I doff the PPE, enter the room and wait for the Skype call to come through. The daughter’s face appears on the screen and immediately I urge her to prepare herself because her mother’s eyes and mouth are open. The woman nods while I try and find the button that flips the camera. I can’t see it. I can’t see it. I keep telling her that I can’t see it.

I try different things, but I can’t find it and I feel like a fool. I apologise, tell her I’ll try my best to line the camera up; my team are too busy dealing to show me how. I lean over the bed holding the iPad above the dead woman’s face. Her daughter is giving instructions: “up a bit, left a bit, no, no, too far, down a bit, left a bit more, there! That’s it! Hold it there.” I have to stop myself from laughing, yet I don’t feel jovial, I don’t feel happy, or elated. It feels maniacal. I do my best to compress it, if it escapes, I fear it will turn into an infinite scream.

My back aches, my arms shake as I hold this awkward position. My face hovers close to the dead woman’s. I expect to feel her breath on my cheek but there’s nothing. The daughter is talking to the woman, telling her she is so sorry this has happened, telling her to “sleep tight.” I hear a man’s voice, the son-in-law saying, “god bless you, rest well.” I hear, “Thank you, that’s enough now” and show my face on the screen. The moment feels awkward as she thanks me. We truly don’t know what to say to each other. I return to my professional default and tell her the deputy manager will be in touch and to, to take care of herself.

I leave the room, donn the PPE and make my way back to the office but I am drawn towards a commotion in the staff room. A large cake sits in the middle of the table decorated with the word ‘HERO’ on the top in rainbow coloured icing. The carers are smiling and making comments about the “lovely gesture”. One of them rakes in the drawer for a knife. I pour myself a glass of water and return to the nursing office before I smash it with my fist down into the top of the cake and I am not sorry.

Wanda McGregor ©