Ostomy

Madiha Bhatti

Scrubs were out of the question. Instead I drew wide black wings over my eyes and painted my lips bright pink and slid on nice fitted pants. I respect death enough to dress up when I expect she’ll be paying a visit. She had a particularly tenacious customer today. JT had “life is rough” tattooed on his right arm and “death is easy” on his left. He did not make it easy.

I started the day asking for morphine. I looked into the attending’s eyes and insisted, “He is dying. His body is an open sore and he can’t tell us he’s hurting. You can see the pain in his eyes.” She conceded to a small dose of oxycodone. Less than 20 minutes later JT’s heart gave up. He was shocked with 200 volts of electricity four times over the course of two hours, and it wasn’t until the nurse noticed a tear leak out of his glassy eye that she pushed some fentanyl. The bitter side of my thoughts turned towards the man in the picture I’d taped to the end of the bed. Handsome, the center of a large and beautiful family, gazing into the lens as if to say that he was aware of the riches that surrounded him. That was the man who had decided that he would squeeze every minute out of this life, even if it meant that he would leave it in a ball of flames. Are you happy now, JT? So goddamn stubborn. You dragged me into your violent end. I had to crack your ribs for the miniscule possibility that you could be with your children again. It was a small voice. I was overwhelmingly focused on the suffering of the swollen, starved, oozing body in the bed. “Baby, baby” I cooed, stroking his matted fro. “Just hold on a little longer. They’re coming to say goodbye and then we’ll let you go. You are so loved, JT. I’m sorry, I’m sorry we’re hurting you.”

I wasn’t expecting any of his children to be among the visitors. But suddenly there was Ross, 18 years old, handsome and whole. His shoulders were stiff, defensive. I only had to put my hand on his arm and he wilted. There are two sounds from the day that I can’t forget. One is Ross’s cracked voice as he spoke to his father. "Daddy, I love you I love you I love you. You have been the best dad. I love you I love you I love you." Was he making up for the times he hadn't said it or squeezing in all the times he wouldn't be able to?

The second sound was the wail of JT’s mother. Mabel was sitting in the car, unsure if she could bear seeing her 40-year-old unresponsive son. When I told her he wouldn’t survive the day she screamed right into the phone. For two minutes I listened to a stranger’s raw agony, the desperate cry of a mother outliving her son. She pleaded with God.

In many cultures the bereaving are not left alone in the weeks following death. The pain is too crushing, too everywhere, and community members take turns simply being present for it, holding up one small corner of anguish day after day until the left-behind can tolerate stretches of being alone without drowning. It was this instinct that kept drawing me back into room 15. That and my own personal stock in the grief. At one point it was just me and Ross. A spontaneous speech fell from my lips. “I was here when his heart stopped. For two minutes I was his heart. I need to tell you that I was strong. That it was my privilege. That knowing how much you all loved him makes me wish I could have met the man who was worthy of it.” I was crying and relieved that it wasn’t contrived.

I told his family that I had come into his room every day and talked to him. Encouraged him, prayed for him, listed off their names. I said that through everything the one thing he was still able to do was shake his head no. That his entire will was contained in that no. He was letting us all know that we were not the ones he wanted. The love I had tried to give him in their absence was paltry in comparison.

I lied to them, I think. Or at least said things I didn’t entirely believe. I said he was calmer with them around than he had been all morning—he had perhaps been waiting for them. I really wanted to believe that. I almost did.

But I also knew that he had been loaded with sedatives before they arrived.This has been my to-and-fro with death. Sometimes I see a spirit trying toescape its dying vessel onto something better, us selfishly grabbing it by theankle until its pull onward becomes too great. Sometimes I feel the spirit hasalready been extinguished, that we were trading goodbyes with a husk.

At some point Ross mentioned their last meeting together. “He saidhe was coming right home.” The most disingenuous thing slipped from mymouth. “He’s going to a different home.” I bit down on my tongue.

I’m writing all this now out of a sense of pride and reckoning. Pridefor how careless I was with my heart when it came to this stranger. I grievedharder than I have for deaths that were much closer to me. A writer friendtold me that she had been so consumed with an idea she was writing aboutthat she felt like it was living outside of her body, that she was sure everyonecould see it, like an ostomy bag. That’s what mourning JT became for me. Iran toward fear and pain so that a man would not spend his last week of lifein the overwhelming company of cold hands.

The reckoning is that I used this man’s death to feed my aliveness. Icelebrated the fact that I, unlike my colleagues, openly wept in the call room.Their business-as-usual attitudes horrified me to the point that I welcomedthe pain. I perhaps deluded myself into thinking that JT needed me. In truthI need him. Learning the details of his life kept me from the cardboard fatethat awaits anyone who turns a life into lab values. I was dying in that callroom as he was dying in that bed. We kept each other’s hearts beating.

-Madiha Bhatti is a fourth year medical student from Highpoint, NC, expecting to obtain her MD in 2021.-