The Cruelty of Death
By Josephine Jackson
Death.
The word itself can be scary, making people uncomfortable. It’s taboo to talk about it openly without dancing around on eggshells. Most people don’t even have to confront it until later in life, in their mid-50s or 60s, when they begin to approach the bridge where age takes its toll.
But Death Herself really isn’t too dreadful. She gets a bad rap. But in my opinion, it isn’t the actual dying of another person that affects us. It’s the loss of that person. The loss of a parent, a sibling, a relative, a friend. The hole that suddenly opens. The affection or other emotions you have attached to that person are quickly trampled and laced heavily with grief.
Thankfully, I cannot write much on the emotional effects that grip us after the death of a loved one. I haven’t had that experience yet.
My career as a nurse, however, has made Death and I well acquainted coworkers.
Before, during, and after Her job is done, I see how people come together for a loved one in the hospital and the different reactions they have…
How they embrace one another and reminisce and celebrate a life that is coming to close.
How they hold quiet and steady, waiting until those last breaths are taken before they themselves let out theirs.
How they quietly contemplate the next steps when they realize all avenues have been exhausted.
How they deny and angrily blame us for their loss of control.
How they embrace a dreadful prognosis with an iron will and a brave soul.
How they mourn with tears, with phone calls, with wails, with grace, with laughter, with family, and with themselves.
These are some of the most raw and real human emotions one can experience, the ones that precede and succeed Death. They brutally tug at people’s hearts and minds, tossing them around like ragdolls. Those feelings are a true terror I do not look forward to facing when it comes time.
Death Herself is not cruel like this. At least, not until She is made to wait.
——
Being an ICU nurse has many quarrels, but one of the worst I face is the blurry, grey area of ethical and moral choices. Each person’s morals are unique to them: what lines won’t be crossed, when to put your foot down, or how you approach hard or uncomfortable topics are choices you and your conscience decide on for yourself.
Through my career, my confidence in my morals has grown tenfold. The lines, of course, get blurry as I come across each new and unprecedented event, but the previous solidified lines act as bumpers to guide me, and my personal reflections affirm them for the next time I face something similar, if I even face something like that again.
There are times where I have such an insane situation come up and I think there’s no way this could ever happen again. But then I am left surprisingly surprised by human nature and how it repeats even the worst of circumstances.
Although there will always be blurred spots, I know I will not ever feel comfortable with the unnecessary prolonging of death, especially when it is completely inevitable. COVID has done nothing but steadily confirm that principle.
Over the past three years, so many thoughts come up when I reflect on this virus and the undoing it’s had on our healthcare workers, healthcare systems, and patients. I hear about PTSD in the field and how nurses, doctors, and respiratory therapists are coming forth with symptoms from working with and around COVID.
Nah, I don’t think I have it. It doesn’t interfere with my everyday life. Only when I think about it, and then sometimes when I don’t.*
When I’m away from work I try to compartmentalize. But there are a few situations that, no matter how hard I try, make their way out of that little box I shoved them in, hidden in the back of my mind:
A man whose kidneys shut down and his blood pressure plummeted, but his family were all symptomatic too so they couldn’t come in. They all said goodbye via FaceTime after I prepared them for his pallid, almost cachexic appearance.
I stayed in there through his whole death holding his swollen hand.
The tearful audio from the phone of a daughter who had to watch her mother’s death via FaceTime, even though she was right outside. Because the supervisor was there, I had to tell them they had to choose who came to be with their mother when she died an unrelated COVID death. Against my supervisor’s orders, I let them stay well over the allotted time limit, but I really wish I would have just told security to go fuck themselves and let the both of them in.
The tortured face of a man who was kept alive with breathing machines when he had necrotic lungs that were literally falling in on themselves is the main memory that pops into my mind unannounced. I check on his widow through Facebook to see how she’s doing, but I don’t think she ever got my letter. Or maybe she did and couldn’t bear to read it. I don’t know if I ever could, if our positions were reversed. He fought so valiantly, but in the end that virus physically tore his lungs apart, from the inside out.
Interestingly enough, of all the people who I’ve seen perish gruesomely from this illness or lack of equipment or healthcare workers, his is the only macabre image I have to hide away from myself. There have been a lot of other people who I’ve seen skinny as all get out, bloody, jaundiced, weak, and swollen past the point of recognition. Death was there, at the foot of their beds, waiting. I don’t ever picture Her as angry. Just disappointed, and maybe a little sad. She’s behind those symptoms, I know. But they wouldn’t hurt anyone if they didn’t try to hold on. I feel Her stare sometimes as she watches me pour over these people, carrying out every order so they stay alive for just a little longer even though we both know the ultimate outcome is Death.
What really matters in that moment is how they die, but it’s hard to bring that up when people see hospitals and doctors and nurses and therapists as miracle workers. I always advocate for the comfort of my patients when it comes to that point. I’ve had doctors pull me aside asking if letting go is the “right” decision, and others argue against me saying we have to do everything we can so the family has some peace of mind.
But what about the patient? What about us?
That’s when this dips back into those blurry lines of morality. When you work so closely with a team and all your ethics and morals begin to come into question, who really gets the final say? In my opinion, the patient is the one and only person who gets those decisions.
But what happens when they can’t talk? When we have to rely on their family, who are starting to be abused by the emotions that introduce Death?
It’s a constant battle of what is right and what is best.
I wondered if I should even share this essay. These thoughts and feelings are so personal to myself and to the people who have experienced Death. I know how jaded and despondent this sounds as I write it. I hear myself think these things when I work, when I have to explain to another innocent mind how Death can really be, or when I hold the hand of a person who is alone because the rest of their family is barred due to COVID or distance or something else.
How terrifying it is when you see your loved one gasping those last breaths.
How agonizing it is to look up at the monitor and see the rhythm flash once or twice more across the screen, knowing that the heart its reading is no longer actually beating.
Is this something that anyone else really needs to read?
But Death is part of life. And I see on media and television and books how people describe Death, never really portraying everything She encompasses. Partially because it’s just not possible. Each experience of Death is different from the last, and the next will be just as different. Different emotions, different reactions, different understandings, different acceptances.
But it’s also partially because She has such a bad image surrounding Her. Death is just as important as Life.
I understand being scared of Her, but wanting to outrun Her and live forever just isn’t something that I ever want to do. And that may be because of what I’ve seen and felt and because I know what happens when you keep pushing Her off to the next minute when she’s there and waiting. But when She comes, I’ll be okay. It’s a little nerve-racking to think of what happens in the exact moment, but my faith helps me feel calm in thinking about what the next part will be.
Although I am actively trying to get away from the bedside, I wouldn’t have it any other way.
I like to think my empathy, my compassion, my mediocre jokes, my kindness, my strength, my altruism, my honesty, my voice, my horrible hairstyling, and my advocacy have made a positive difference in my patients’, their loved ones’, and even my coworkers’ lives, and sometimes deaths.
I like to think I help to bring love, understanding, and maybe even a little bit of calmness into these rooms when it sometimes seems more cold, unfamiliar, and chaotic. Even if it isn’t always that way, I know sometimes I do provide at least a little bit of relief.
Death is really not all that scary. The emotions and decaying that come with her are pretty bad.
But Death herself is not cruel. Not until she is made to wait.
——
*Author Note: PTSD is a serious mental disorder. Symptoms include nightmares or unwanted, intrusive memories of trauma, and increased emotional reactivity (becoming quick to anger, depressed, etc.).
This part of my essay was partially sardonic, as I know I recognize those signs in myself. Throughout my life I’ve dealt with severe anxiety, depression, and suicidal ideations. I am fortunate enough to have built a healthy mindset when confronting mental illnesses and feel comfortable sharing this because I know I have the support system and tools to approach and deal with it.
Josephine Jackson (or Josie or Jo or Jojo) is a travel nurse and writer based in Colorado Springs, Colorado. This is her first essay for Dead Foot Collective. One of her favorite things to do in any new city is find all the coolest museums, the most scenic hikes, and the best foodie places.
