Last updated on March 25, 2021
"I will love the light for it shows me the way, yet I will endure the darkness because it shows me the stars." - Og Mandino
A young, capable doctor stood before me resolute and dutiful. “We’re going to have to intubate. We have to do it now.”
My wife Tammy had spent the previous three weeks in the intensive care unit at the University of Utah, deathly ill from a failing liver, and now pneumonia. She had gone into the hospital initially because her abdomen had swollen so badly that she could not keep any food down and she was having difficulty breathing. During the progress of her illness, she developed varicose veins in her esophagus that had to be periodically “banded” (cauterized) to prevent them from rupturing. Without the banding surgeries, she ran a high risk of tearing one open and bleeding to death internally. That is what they thought happened to her when she first entered the hospital, so they treated her for that, only to find that she was simply bleeding from a small sore in the back of her throat. But she threw up a little bit when they pulled the scope out and ended up breathing in a small amount of vomit. That is when she contracted pneumonia.
“Keep her alive,” I said. “Do whatever you have to do to keep her alive. Do you understand me? You do whatever it takes.”
He and his team were already preparing for the intubation. “You don’t want to be here for this.”
I stumbled toward the swinging doors at the end of the hallway. Doctors and nurses passed by as I fumbled my way to the visitor’s lounge. Tammy was screaming in torment as they forced her to take the life-saving tube into her throat. The sound of it was like a gun in my ear. She was in anguish and it was all my doing. The sheer guilt of it was overpowering. We had spoken about it more than once. I was to do everything I could to keep her alive, but she did not want to be kept alive by artificial means. It remained to be seen whether she would survive the intubation. They assured me that it would only be for a while until her oxygen levels came back up and she was able to breathe on her own. She still had a chance. I had no choice. I couldn’t just let her die.
We had been in the ICU for more than three weeks. I stayed with her and slept on one of those makeshift, rubber guest beds that turns into a chair and visa-versa. The sheets didn’t fit, and they came loose during the night. I really couldn’t sleep anyway. The blankets were thin, and the floor was frigid and antiseptic. There was a constant, auditory barrage of buzzes and beeps from the IV units and the monitors, and her respirator unit. I was tuned to every fluctuation in her oxygen levels, every beat of her heart, every tiny ding and blip. I cleaned her up when she soiled herself so the nurses wouldn’t see. I stood at the foot of her bed, warming her cold feet in my hands. ‘Breathe, baby. Breathe.”
I tried to stay busy when she slept. I spent quite a bit of time in the hospital cafeteria, which had quite good food as I recall. I made friends with the doctors. (I was, after all, there for nearly a month.) I would wake in the early hours of the morning and walk by the doctor’s station swinging my arm awkwardly. “It hurts when I do this.” They would laugh empathetically knowing that I was just looking to inject a bit of levity into an otherwise intolerable situation. They were all wonderful, loving people. You would have to be, to put yourself through what I was going through every day just out of a concern for others. I cannot fathom the depth of their sense of loss.
She was childlike, laughing, sticking her tongue out playfully. It took me a bit of time to realize that she had suffered some fairly significant brain damage during the intubation… Even then, only a couple of hours before her death, it hadn’t yet occurred to me that she was dying.
My in-laws Jerry and Rose came to be with her. She was unconscious when her children and the rest of the family came. Her dad, Jerry, stayed with her on a couple of occasions when I had to make short trips back home, 180 miles away. They were there with me when the doctors pulled the tubes out. Tammy’s oxygen had gotten better and the tube needed to come out before she was no longer able to breathe on her own. She did, for a little while, with the help of a respirator.
“Five days, Sweetie. That’s how long you were down – five fucking days.”
She was looking at me and talking through the transparent mask of a respirator, but she wasn’t making a lot of sense. She didn’t understand. She was childlike, laughing, sticking her tongue out playfully. It took me a bit of time to realize that she had suffered some fairly significant brain damage during the intubation, undoubtedly from a lack of oxygen. Even then, only a couple of hours before her death, it hadn’t yet occurred to me that she was dying.
I went to speak with the doctor about how we might manage her treatment now that she was no longer intubated. The doctor was gentle and understanding as I laid out my well-thought-out plan for Tammy’s treatment. She patiently let me speak my peace and said, “Rick, Tammy is not going to survive without the respirator. We have done all that we can do. Her liver is gone and her kidneys are shutting down. You have to decide now whether you want to keep her alive, or whether you want her to be comfortable.” Her words cut deep. I had just left Tammy’s room. She was smiling, laughing. It was inconceivable that we had reached the end of our journey together.
Tammy didn’t want me to keep her alive under these circumstances. She wasn’t going to be ok. She wasn’t going to recover. She was going to die and there was not a damn thing I could do or say about it. We had been together for 22 years. I still loved her. All I could do for her is make certain that she did not suffer in her last moments.
The respiratory therapist removed the respirator and they gave her morphine. I held her hand gently as her breaths drew shallower. She took fewer and fewer breaths. They grew weaker with each passing moment. Finally, she took one last, shallow breath. I heard the sound of the heart monitor go flat in the hallway. My own heart sank below the foundation of the building. “I love you,” I said. “Let me kiss your beautiful face one last time.” Tears streamed from my eyes. She died at 10:37 am, October 18, 2018, just a little more than a month shy of her 51st birthday.
The doctors came immediately into the room. They were monitoring her from the nurse’s station and could see that she passed. I grabbed my head with both hands and screamed, “What the fuck? What the fuck???” Jerry and Rose were frantic. I wanted to crush my own skull. The doctors and nurses flooded into the room. The resident and I embraced. She knew what we had been through because she had seen it thousands of times.
“We’ll take care of her now.”
I immediately began gathering her things from the closet and the drawers as her lifeless, swollen body lay on the bed. I was profoundly sad, angry, and frustrated with the utter absurdity of it all. Her shoes, her pajamas, her coat, her toothbrush, the new, gray hoody I bought for her to wear on the ride home, things she would never need or ever wear again, all quickly stuffed into a plastic bag to make room for the next critical patient. The cadaver on the bed was not my wife. The woman I had been with for 22 years was not in there anymore. It was just the beautiful package she came in. It was time to leave.
“So, that’s it? We just leave?” Rose asked as we left the room.
“That’s it, Rose. It’s time to go.”
I had not slept in days. My sister offered to let me rest at her place, but I just wanted to go home to sleep, and mourn. And that’s what I did. I slept for days while my father stayed and helped take care of my animals. Tammy’s funeral was small, but friends and family came to say goodbye. My poor dog Shadow was sick at the same time and had to be put down not a week later.
A week after the funeral turned into a month; a month turned into a year; then one year turned to two. March 3rd this year would have been our 20th wedding anniversary and our 25th year together. We were married on March 3, 2001, five years to the day after our first date. We raised two, wonderful children, and although we separated, we remained very close. She was my best friend and I took care of her to the end, just as I promised on the day we married.
The allure of romantic love and the desire for sex drives us to mate and reproduce. Indeed, it is the desire for sexual gratification that drives our species to perpetuate itself. It is, fundamentally, what drew me to her…
After I finished law school 27 years ago and began to practice, I had no real interest in a wife or raising children. My interests were purely selfish. I dated prolifically and played in a rock band. I bounced in a bar and drank a little too much. Then, I met Tammy and her children. I fell deeply in love with all of them and began to realize how important they were to me. I wanted to love and protect them. I wanted them to be my family. Things were crazy for us in the beginning, but I soon realized that I was a father to her children and maybe I would have to be a little more grown-up. One year together turned into two; two years turned to ten; ten years turned to twenty. Seventeen years in, we separated. Things were never the same between us after that, but we stayed close and I brought her home to take care of her when she got sick. That’s what loving husbands do.
When we are young, love is nothing more than an abstract concept, a romanticized ideal perpetuated by worn-out fairytales and cheesy movies. We know we love our parents and our brothers and sisters, and our culture tells us that we should fall in love and marry one day, perhaps even raise a family. The allure of romantic love and the desire for sex drives us to mate and reproduce. Indeed, it is the desire for sexual gratification that drives our species to perpetuate itself. It is, fundamentally, what drew me to her.
Unconditional love, even the ability to perceive its existence, changes us. At some point in the journey, we begin to recognize that love isn’t about passion and sex and romance and having fun. It is something much, much deeper. True, unconditional love is holding someone’s head while they throw up in a bucket because they can’t hold their food down anymore. True love is helping them get to the bathroom, wiping them clean when they can’t do it themselves, and feeling privileged to do it. True love is caring for another human being more than you care about yourself, or even life itself. True love is being there to hold someone’s hand when they die.
Shakespeare told us that all the world is a stage, and we are all merely players. Like characters in a play, we must, each of us, undergo an arc of change. At the beginning of this play, my character’s family was alive. He had little concern for others beyond his own, immediate family. He was arrogant, discourteous, brash, full of himself. Time dragged from one hour to the next. He seldom thought before speaking, and often made others uncomfortable. During this play, the author chose to eliminate many of the characters closest to him: a child; a mother; grandparents; a best friend; a wife.
My character has withdrawn. He feels himself separating from the world. Trust has become more sacred, and difficult to find. He has little in common with those who have never felt the pain of love or loss. He realizes that his pain is no greater than anyone else’s and that maybe he thought a little too much of himself as a young man. He no longer revels in the world and has little tolerance for people generally. Time passes more quickly. He is loath to reach out beyond the small circle of trusted people he calls friends. The recent pandemic has only hastened his retreat from the remainder of the cast. For some, loneliness and isolation can become an addiction. It is the consequence of one’s reticence to love again, having once trusted in those unworthy of it, and having witnessed the pain of others when trust is broken. Like the others, his character too shall perish, sooner than later, well before the third act.
We see life through a series of lenses, unique to each of us. In the beginning, our vision is fresh and clear. But the world gives us a pair of glasses, and each experience thickens and distorts the lenses in unpredictable ways, alters the passage of light through them, and forever changes the way we perceive the world. In the end, some see better; others leave blind or wanting. If there is any moral to this story it is that life is short and precious. Everyone deserves to be loved, and everything we do – everything, matters.