*An updated version of this post has been published in the August 2017 Reflections column of the American Journal of Nursing. The published essay can be found here:
We are intimate strangers. I have heard intimate details about your childbearing history and recent life. I received report and I suddenly know a lot about you. But to you, I am a stranger, your nurse, entrusted to walk intimately with you through the most devastating eight hours of your life. These are the eight hours during which I will check your baby’s last vital signs. Confirm as we have been that there is no longer any response to the outside world. Talk with you about how we will prepare to withdraw life support from your beloved baby. How do you talk about this with a stranger unless the stranger knows how to be intimate? I am praying to God for grace to know how. By the end of these eight hours, I will have played an active role in your baby’s body shutting down, overtaken by the most sudden and mysterious disease, as I push the buttons that will stop the medicines which have kept that heart beating, kept the blood flowing into those little feet that you cannot stop kissing, because you are a good mommy, kissing your sweet baby’s feet. I am a nurse, a caregiver, and all I want to do is help give some little lives another day, another chance. Does my work today also make me a life-taker? In my head, I know it doesn’t. In my heart, it’s a little less clear.
You know his soul is no longer with us, but you are a good mommy, and all you can do in his final hours of physical life is snuggle into bed with him despite all the tubes and lines, and sing what must be a familiar childhood song in your native tongue to your sweet boy. Your singing began, steady and lovely. I quietly did my work in the room, a stranger beholding this intimate aching moment of connection in the realm where music takes us past the barriers of brain-death and a baby’s motionless arms, and brings a mother back to a place where she snuggled her squirmy baby at home and sung this song until his arms grew quiet not with death, but just a night’s sleep, ready to reach out for Mommy’s arms in the morning. Your voice quivered, and my heart quivered for you as I imagined your heart aching for those carefree nights. Your singing stopped because you can’t choke with tears and sing at the same time. You took a deep breath, and you began singing softly again. I am a stranger, so I left your room to give you full privacy to this intimate time.
You are his mommy, and so you asked if we could put him in his own clothes so he was not just a dying child hooked up to machines and medicine, he was your boy whom you dressed every day. As we quietly moved his arms together through the sleeves, I had to tell you, “You are a good mommy.” I had heard you blamed yourself, though I am a stranger and you don’t know I know this about you. But I had to tell you, you are a good mommy. You dropped your head and shook it back and forth. “I am not a mother anymore.” My heart broke into a thousand pieces and I had to tell you, “You will always be a mother.”
When it came time to withdraw the life support, it was too much for you to watch. You pleaded with us through tears to please be gentle with him. When it was all done, you returned to hold your baby in your arms one final time. It was the strangest act for me, to put your deceased child in your arms, as if I was all at once giving to you a beautiful but most terrible gift, and then leaving you alone to figure out what to do with this. All I could do was quietly whisper, “Take as much time as you need.”
As you prepared to leave, you asked me to keep his sweet blue blanket over him. I didn’t have the heart to tell you he would be shrouded. I never want to be the one shrouding anyone, but tonight this was my final act for your child. I hope you never know this about me. I hope you remember me as the one who kept your child tucked into his familiar blue blanket until the end. I am so sorry. You’ve been such a good mommy and I’m sorry I had to shroud him. I tried to be gentle. And then I wept for him, and for you.
I know I don’t know you. I cannot tell your story but I can tell you what I have seen. And what I have seen is that you are a good, good mommy. Know this, and keep it always in your heart.