Pure Sunshine goes dim

Getting my son ready to go to preschool today, I barely had time to just grab some jeans and a long sleeved gray t-shirt to throw on and get him out the door. On the way there, it dawned on me that the clothes I am wearing right now are the same ones I wore three months ago exactly.

Why would I remember such a mundane outfit?

Three months ago today I lost my brother. He was forty. He had a stroke, out of the blue, completely and utterly unexpected, while driving with my seven year old neice in the car. He had just dropped off his three year old son at daycare and was headed home, where he was a work-from-home dad. Luckily, my neice was in her booster seat in the back of the van, and she was unharmed when they struck a tree.

What followed was thirteen days of neuro ICU, induced coma, craniotomies, worry, fear, and love. My parents flew
in from Arizona, I flew in from Texas, and we converged the night after the stroke occurred. He was intubated, had already had a piece of his skull removed to try to give his brain somewhere to go as it swelled, but he was following commands and could squeeze our hands or raise his right arm or leg in response to questions. As the night wore on, those responses became less and less until they were simply gone.

Seeing my big brother, six feet tall, tan, in good shape, with half his head shaved, hooked up to all the machines and drips and monitors that I knew so well from work was jarring. I tried to be a good family member and balance that with being a good patient advocate. I thought back to telling the families of the kids I took care of to not look at the machines, the numbers, the monitors and to look at their loved one and focus on THEM. I tried. But I looked at the ventilator and wracked my brain for ways to make it breathe better for him. I looked at all the equipment and had to restrain my hand from suctioning his lungs or retaping his ET tube. I looked at the number of drips going into his IVs and thought back to day one of my clinicals in that very same hospital ICU (Instructor: How do you tell at a glance how sick a patient is? Look at how many drips are on the IV pole and how many sets of numbers are flashing on the monitor. My brother had almost as many as I had ever seen on a patient). I looked at the large black area on the CT scan, showing that 60% of the left side of his brain was no longer functional.

We sat vigil, trying to offer anything but feeling powerless. My sister in law is a cardiac nurse. He sister’s
husband was a Cadiac surgeon. I was a respiratory therapist with a decade of ICU experience. The hospital staff joked that we could open our own hospital. But none of us really knew neuro, and having just enough knowledge magnified the fear a thousandfold. I didn’t know everything they talked about, but I knew that overall it was bad.

We had moments of hope. But, as anyone who has watched someone go though an ICU stay, it’s usually one step forward, two steps back. And as anyone who has worked in an ICU knows, you can’t keep the mask on at all times, and after my brother’s third CT scan, one look at his nurses face told me.

It was time to have The Talk. The swelling had spread to his brainstem.

We weren’t going to get Eric back. We could keep going, but he would not be Eric ever again. It was time to make some decisions.

Organ donation was the first one. Yes. Absolutely. We all agreed that he would want to help others. He was a very generous person so this was the one gift we knew he would want to give.

After that decision was made, it dictated our other choices, because time is of the essence in organ procurement.

We had time to say our goodbyes, for his kids to come in and give him hugs and kisses and wrap his hand around theirs. I made a playlist of a few of his favorite songs.

I’ve been there in this situation before, only on the other side, helping parents say goodbye to their children
forever. I have been the one to turn off the ventilator or remove the breathing tube. I’ve always had empathy
for the families, but now I’m not sure I can go back to that. I appreciated our nurse, who shed her own tears.

We surrounded him in the OR prep room, dimmed the lights, had his pastor say a prayer, put our hands on him, played his music, shed our tears, told him it was okay and that we loved him. His wife was nestled in his arms, ear to his chest, and heard his last hearbeat. We all watched the man who my aunt aptly called Pure Sunshine dim and fade away.





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