The conversation ceased mid sentence as all the nurses listened intently to the coughing in the next room followed by an eerie gasping for air. "Will they need help clearing their airway?" was the question on all our minds.
It was just after dusk and all the clinic staff were meeting in our little pharmacy to discuss the plan for that night. We had just admitted two new in-patients making a total of five. We were all exhausted. We each had been getting up every other night and sometimes more often in order to check on our patients and keep on track with their medication's schedule. This had been going on for more than a week and we still had to run the clinic during the day. In assessing our own energy levels it was decided that Carrie and I would be the nurses on duty for this night. After getting all the meds ready and setting up our bed in the middle of the clinic we nestled in for what we knew would be an eventful night. We set our alarms for our first round only an hour and a half away. As I laid there looking up into the rafters I was suddenly filled with joy as I thought about my situation. I had no idea where I would find the strength to get up and help our patients, but I was just happy to be there and to serve. After calling on God to be our help we quickly fell asleep.
Our five patients that night were Bisita a women about 45 or so who was suffering from TB. Jinilin, Mingga, and Irlin were sisters who we expected all had pertussis or whooping cough. And then there was Maman. He was still with us. It was only five days earlier that he had his series of mini heart attacks. Although he didn't recover immediately, the following day he had his appetite back, was walking around, and having a great time visiting with people. There was no explanation for it other than a miracle. It was so good to see life return to him, but his miraculous good health didn't last long. He soon began to deteriorate again. His pain came back and his oxygen saturation dropped very low. Everything we tried seemed to be in vain. We didn't know what his outcome would be. The alarms went off. I woke up from a deep sleep and felt extremely groggy. Struggling to put to-and-to together in my mind and then getting my body to respond to my brain took a while, but eventually I was able to get my self out of bed and help Carrie do assessments and get the meds to our patients. All was good so far. We headed back to bed.
As the night continued the girls kept up their coughing spells. Carrie repeatedly got up to help them clear their sputum so they could breath again. I felt as if I was fading in and out of consciousness. I would wake up to the coughing, hear Carrie scramble out of bed to help, and then I was out again as there was very little that two people could do to help. Sometime after midnight a major rain storm swept in with vengeance. It pounded our tin roof making a very abrupt volume change. As my brain fumbled to find the meaning of the sound, rain began splatting my face. Finally my brain had clarity. "A typhoon just hit. I am in the very center of the clinic and I'm getting wet, and Bisita is on the back porch. She must be getting drenched!" I sprung into action quickly getting Bisita with her IV inside the clinic while Carrie closed the patients' windows. Even though it wasn't our scheduled time, Carrie decided to get an assessment on Maman while I got dry sheets and cloths for Bisita.
I felt a tap on my shoulder. It was Carrie looking a little more wide eyed than normal. "Kasia, I think he is dead. Can you come and listen?" Carrie and I just looked at each other for a moment. I grabbed my stethoscope and went into Maman's room. Looking at him under a head lamp his eyes were closed like he was sleeping. I put my stethoscope to his chest... nothing. There was no bounding heart or loud breathing as before, just stillness. I stayed listening for a little while partially because there was family in the room and I wasn't prepared to break the news, and partially because I needed the extra time to process the passing of a life. We had all been expecting this, but no matter how much you prepare for it death just isn't natural. As a nurse I have listened to many heartbeats and breath sounds, but I will never forget the lifeless sound I heard that night.
Our first course of action was to wake up Ellen Grace our head nurse. We tried to keep everything low key as we knew our other patients would be very afraid if they found out someone had just died. All the family members who had been staying with Maman except for one went to go notify family even though it was dark and still raining. The funeral would be the next day and each family member needed to be told in time for them to come if they wanted to.
As the night wore on family members who were close by began filtering in. They congregated in Maman's room and spent the time together talking. We were curious what would happen come day break.
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