Bessie, some three score and ten years old, lay on the backboard motionless.  Her old, gray head was surrounded by great orange blocks of foam; her neck encased in a hard plastic collar.  Straps criss-crossed her body, as if she might make some miraculous attempt to escape.  As if we strapped her body down so it wouldn’t float away, though she was already floating, I suspect.  Oxygen passed into her lungs from the tube that protruded from her dry mouth.

She was found slumped in the floor of her nursing home. God bless those paramedics, whose skill revived her dying heart and who, with strong hands bound her top to bottom for her ride to the emergency room.  They snatched her from something; from death a while, from life a while.  But she arrived and she was ours.

Standard stuff.  No one knows quite what happened.  But we knew a few things.  She did not breath.  She did not wince from any pain.  She did not startle with any sound.  And she appeared as old as Methuselah.  Older than her years.

I did have some information.  She was a long-time resident of a local assisted living center.  She was profoundly retarded and always had been.  She was blind.  And all she would do was suck her fingers and try to sing some hymns.  Maybe she mumbled ‘Amazing Grace’, or ‘The Solid Rock’, slurring words and verses, annoying passersby.

It suddenly seemed so easy!  She had a cardiac arrest.  She was probably a ‘no code’.  She was going to die with no one around.  The nursing home would tell me, ‘she has no family.  Some old friends stop by sometimes, but no one checks on her.  Do what you think is best’.  All so easy.

Until they gave me that cussed (two syllables, please) phone number, and told me she was a ‘full code’.  No one had ever filled out the ‘blessed’ paperwork for this retarded old lady.  Fine.  I called her sister.  I expected more ease.  ‘No, I’m her only family.  I don’t want you to do anything.  I can’t come over.  Just call me when she passes’.

But to her credit, Bessie would not leave me alone.  Bessie had a message for me.  Bessie was speaking through her silence, through her loneliness, through her confusion and into my busy day.  Bessie was standing with one food in heaven’s gate, looking back and talking to me.  And laughing! What her sister actually said was, ‘I’ll come right over.  I’m calling her other sister, her brothers and her nieces.  We’ll be there as soon as we can.’

And they filed in, slowly, until they were all there.  All of her siblings were older.  All of them seemed weary, like this was just one more piece of sadness in a long sad story.  Any of them could have been lying on that backboard that day.  But they sat in assorted chairs and touched one another.  Their eyes swollen and red, tears on their sagging, age lined faces.  They sat there and looked at her.  They looked at her like she mattered.

I told them the score.  What I knew, by the time they arrived, was this: she appeared to be having a large MI.  But she also had a large cerebral hemorrhage and her brain was already herniating.  I wondered, ‘is it really an MI, or are the EKG changes from her brain bleed?  Or did she have an arrhythmia and then fall, hitting her head?’  And then I thought, ‘who really cares?’   Her family certainly couldn’t care less about the fascinating cause and effect of medical science, that thing that makes doctors call terrible events ‘interesting’.  I really didn’t care either.  It’s hard to care about things you can’t change.  I knew what had to be done.  I knew I would be her doctor, start to finish.

We took her off of the backboard.  I told her people everything. I told them she was going to die as soon as we stopped breathing for her.  They understood and waited for everyone to arrive.  They told me she was their baby sister. They said it like they remembered how precious she was, simplicity, drooling, singing and all.  They said it like she was worthwhile.  They all wanted to be with their old baby sister and hold her hand as she fell asleep the last time.

Finally, it was time to put an end to the futile.  With all her local kin at the bedside, I deflated that cuff and pulled out that tube, and we put a little oxygen over her face and watched.  Tuned in to modern medical drama, her brothers and sisters and nieces and nephews watched the green blip of the monitor until I turned it off.  People have watched death a far site longer than there have been heart monitors.  None of us needed to see the plummeting oxygen saturations or the transformation of heart beats into flat lines.

Bessie never drew another breath.  Some three or four hours after she arrived, we let her walk on through the door to glory, where the hymns’ final verses are all written down.  She walked through smiling, blowing kisses at her family.  Baby sister, all grown up at last.  She walked from confused infirmity into forever perfection, waiting and hoping for them all to come to her in due time.  At least that’s what I believe.  I think it’s what they believed.  She left behind a place where some might have considered her pathetic, her life meaningless.  But in her years of hymns mumbled in the dark of her blindness, she focused the love of a family into rare clarity, and helped to teach us that what is worthless to some is a treasure to others.

She sang as she looked back, sang in a clear voice, eyes clear.  Maybe that last verse of ‘Amazing Grace’, ‘When we’ve been there ten thousand years, bright shining as the sun…’.  And we covered her old house in plastic and went our separate ways.

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