The ward was quiet and still. The hallway lights seemed too bright for this late hour. I could hear hushed tones from the nurses huddled at the desk down the hall. I got to her room just after midnight, already behind schedule. I looked in, my eyes slowly adjusting to the light.
She lay so still I couldn’t see any movement with her breathing. A full moon hung centered in the window, silhouetting her and casting shapeless shadows around the room. A lone rose leaned out over an oversized vase on the bedside table. I couldn’t make out the color in the grayness.
“This is my last full moon,” she said, startling me.
“Oh, I didn’t want to wake you,” I said, after hesitating a while, then perfunctorily introducing myself as the medical student.
“I don’t sleep anymore.”
“It’s that bad?”
“I wanted a DNR – to stop all of this. How many times can I do this?” she said forcefully. “They said another treatment could knock this down again. I always feel so bad after. At least they let me have the DNR this time.”
“No one can force you not to have a DNR,” I said, trying to sound confident.
She described how her physicians didn’t like it if they were going to treat her cancer. But this time, she said, it was her only condition for going through chemo again.
I was a bit confused, like this was backward – she doesn’t want any treatment, yet here we are. I thought of the hospital stays, the chemo and other meds, the nurses, the labs, and so on; yet she wanted none of it.
She lost her husband a few years ago, he was sick for a while, and she hasn’t spoken with her two kids in years. She didn’t say why – I didn’t feel like I should ask.
She stared at the moon for a while. “You don’t have to check on me. I know they said someone would come by after the chemo today, but there’s no need. I’m not going to take any more of it anyway. I’ll tell them first thing tomorrow. Don’t worry about me.”
I didn’t know what to say. I asked if I could listen to her heart and lungs, and if she had any symptoms. She looked at me and chuckled. “Sure, go right ahead – you guys need to learn, right? You look so young, running around in your white coats.”
I asked her to sit up. I turned the light on over the head of her bed. She looked much older than sixty-five. Her skin was paper-thin, covered in bruises and excoriations. She said she scratched a lot because the medications made her feel so dry. I couldn’t get the stethoscope to sit flat on her back because her ribs protruded so much. She took a few breaths, then lay back.
In the light, I could see the color of the rose – bright yellow. I mentioned how pretty it looked. She told me yellow roses were her favorite and that a nurse she knew from a previous stay gave it to her.
“I’ll check in with you again before your team arrives in the morning.”
She said that it was very nice, but unnecessary, that she’s too tired for any more of this. I said I would at least stop by to say hi on my way to morning report. She just looked at me, and then turned back toward the moon, which by now was closer to the edge of the window.
We both looked out at it for a time, then I glanced back down at her. She was sleeping. I turned off the light and backed out, closing the door against the light of the hallway.
I worked most of the night, finally getting some rest around four o’clock. The pager buzzed me awake almost two hours later. After clarifying some orders on a new admission, I ran back to see Ms. M before heading to morning report.
Her room was empty. I looked for her name on the door – maybe I was on the wrong floor. Her nurse saw me and came over. Around four, Ms. M asked her for help getting up to take a walk in the hall. When she eventually got to her, she was not breathing. She couldn’t feel a pulse. Honoring her DNR, she called the intern to see her and take care of the usual paperwork. They decided not to call me since I had been up so late.
I stood at the doorway, staring into her empty room. “I was just talking to her,” I said to no one in particular.
Even the rose was gone. I walked to the window and looked out – the moon had already set. Alone.