It is very quiet in the donor room. I try not to imagine the sounds made only days ago by the six-year-old boy now lying motionless, lifeless, under the paper drapes covering the sterile surgical field. Instead I move through the setup of instruments, sponges and sutures.
I resist temptation to wonder if he played baseball, pulled his sister’s hair, embarrassed his parents by trying to burp louder than his cousins at a family barbecue or squealed with glee as he wrestled his dog. I push away the image of him fighting bedtime but saying goodnight to his mother. “I love you Mommy.”
I call all my training to the front lines in the battle to silence my heart. I focus on the rhythmic hum of a breathing machine pushing air through a tube and sending oxygen to organs that will be harvested and placed in other children’s ailing bodies. The machine’s voice, despite my focus, stays on the periphery of the quiet that rests on those in the room, especially the precious little gentleman in our care.
The surgeon stretches his hand toward me. For a little over a second we make eye contact. He says nothing. I need no words. I place the scalpel in his hand, and it begins.
At twenty-four years old, I am a skilled and practiced professional. I know this is not the time to attempt dialogue. I don’t expect the banter and camaraderie I’ve come to enjoy in other operating rooms and different situations. Carts carrying patients roll past the closed door but are of no consequence to me. I take no notice of chatter at the scrub sinks.
I don’t take the chance of stepping from behind my mask of honed precision to ask the question that will reveal my humanity. I stay well-guarded behind gates of routine. I move methodically, efficiently – the mental equivalent of one foot, and then the other. I proceed alongside the doctor also stepping one foot, and then the other. We have done this dance before. We know the choreography by heart.
This child is my patient. He has been declared dead by technical and legal criteria. But in this room, in this hour, under these lights and with all I can offer without breaching professional boundaries, I treat him with the same care for his dignity as I do those patients who have not departed this life. I gently touch his draped leg in attempt to connect with his little soul and let him know someone is here. He is not alone in these last silent hours.
The surgeon puts his hand out. I respond. I place one foot, and then the other. My eyes are the only visible part of my face. I will them to continue scanning the field in anticipation of the physician’s needs. I order them to lock tears behind stoic lenses unclouded by emotion. I hold the sacred hush with tenderness in gloved hands. I am one of the last to feel life’s warmth in this little frame. I am noiseless as I again touch the small draped leg close to where I stand.
At the procedure’s conclusion, I attend to legalities of paperwork, head to the locker room, strip off the surgical clothes and step into the shower. I wait in hot water pulses for the answer that my youthful mind insists will come if I just keep asking. But it does not come. I am tired. I rest in the void of the unanswered inquiry with trust. It’s all I have. I surrender.
When I step from the shower, I dress and leave before the rest of the O.R. crew gathers for our nightly pilgrimage to the College Inn for enchiladas and half-priced drafts. No food or drink tonight. Not tonight. I start the short walk to my apartment on the edge of the hospital campus. I am alone.
My shoulders slump under weight of thinking, not for the first time tonight, about the boy’s parents. Where are they? Do they know their treasured child was not alone in the end? Do they understand he was treated with tenderness and love until disconnection of breathing machines? Are they holding each other in the shadows of both losing hope and giving hope in the same moment, with the stroke of a pen?
I am two blocks from the hospital. It is safe for tears to flow, unrestricted by professional protocols. No permission is needed; none is sought. I move on and am careful to place one foot, and then the other.
Tomorrow I will start a new day and return to work. Perhaps I will help alleviate suffering by assisting with a gallbladder removal or repairing a broken hip. Maybe I will witness the miracle of new life at a baby’s birth. But tonight, tonight I think only of the little boy who slipped from this world into the next with me at his side.
At home I sit motionless, pensive, in awe of life and with respect for death. And I remain very quiet.
Copyright May 2017
Laura L. Padgett
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