A View of Infinity
SAEM PULSE | MARCH-APRIL 2021
By Ray Fowler, MD
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It’s a long time now, over 40 years in the emergency department, lingering over case after case, thinking and reflecting on the prolonging of life. Years ago, my attorney brother and I were at the bedside of our mother, struggling against the BiPAP that was supporting her breathing during the sepsis from peritonitis that was taking her away. She said, “Let me go!” and we sadly went to the desk — after we conferred with her and then together — and signed the DNR form that would lead to her being moved to a morphine drip at a hospice called “Tranquility.” The typical staff member there had spent 20 or more years as ICU nurses: Years spent helping people check back in. Now they were lovingly helping patients, like our mother, check out with love and grace. I have never witnessed more loving care by such gentle souls. At the end, the peace that passed all of our understanding that came
over our mother had no reference that I could describe. In one moment she was sleeping and breathing softly, and then the next moment she lay still, amid a vision she must have been having of an infinity that opened before her. Somebody had told me years before that the first dream you have of a loved one after they pass tells you how they are spending eternity. Not long after my Dad passed after a sudden heart attack in his 80s, I dreamed that we were all at a party, wearing formal wear, and my Dad, a little smaller in stature but so real in my dream, was the life of the party! I knew that he was doing just fine in the hereafter. After Mom died, I had to look inside with the passing years to find my own comfort with that “view of infinity”: The giving over of life to embrace a hereafter that, with those of faith, we aspire for a measure of confidence in our universal continuity that transcends our last breaths, our final heart beats, that is
measured in significant part by the love of those who remain behind, and is lodged in our minds as we approach the final adventure of life. He was a bit younger than me, lying there writhing with his back pain. A colon cancer survivor, he was now having a moribund, unrelenting lumbar agony that had worsened over the last few weeks. He said, “I hoped it would go away, but it didn’t.” His pallor, his tachycardia and diaphoresis, his drawn face all murmured to me that this had the chance of not being a diagnosis that either of us would want to know. And, indeed, on the CT scan his bones were riddled with metastases, his acute pain caused by the severe pathologic compression of his second lumbar vertebra. This was as bad a prognosis as it could possibly be, and I made arrangements to admit him for pain control and what care our wonderful cancer team could offer.
