A Good Death

Why Is It So Hard to Find Solace in Intensive Care?

March 20, 2014

Healthcare Partner, NBBJ

The intensive care nurse hovered outside my father’s room, trying to be discreet, but watchful. It was awkward for her.

Inside the room, just a few hours before, my father had recited some of his poetry to his two grandsons over the phone. Even though his deep, resonant voice was impaired due to intubation, he was determined to share his perspective and wisdom on life until the end. My sister and I sat on either side of the bed, reaching up to make physical contact with the man who had held us in his arms as children. His arms were still surprisingly strong.

It was a brand-new intensive care unit with all the marvels of modern technology, but lacking a soul. Hours spent in discomfort while trying to comfort our father in his last hours made it painfully clear that the designers had focused on the technical brief but had forgotten that it is people who inhabit these places of extreme emotion. The bed was in position for medical staff access; our chairs were at sitting height. The only way we could look at our father was to stand. No one had thought about the long, long hours the family spends at the bedside.

Was this a good death? Perhaps. But we seem to collectively forget that death is for the dying and for the living. When my father finally took his last breath, we were overcome with his loss. My sister and I held each other and wept. It was now just the two of us, both parents now being gone. The nurse who had been hovering for most of the night quietly entered the room, having seen from her monitor that our father had died. “We will take care of all the arrangements,” she said. Suddenly, after a long vigil of ups and downs, we realized in a very different way that it was over. We were being gently prompted to move on.

I stood, tears still streaming from my face and asked the nurse how she handled being in an environment like this, filled with fear, sadness and grief? She quickly answered, “Oh, we’re all used to this.” I looked her in the eyes and told her that I design places like this for a living and asked again, “How do you handle this?” I could see her guard drop. She slowly and quietly said, “We don’t. This is a brand-new intensive care nursing unit,” she continued. “There is no place for the nurses to have a moment of respite, a place to gather ourselves, make peace and soldier on. There is no place to feel the sun during the day.” She turned away to attend to my father’s body.

My sister and I walked out into the hallway in a daze, not quite certain what to do. We wandered the mind-numbing maze of bland corridors trying to find our way back to the entry. These are the places we design; of life and of death; the most sacred of human events. We have such a rare privilege and responsibility. So why hadn’t someone thought to provide a place of solace at the intensive care unit? Didn’t they realize what happened here?

As we found our way to the lobby, holding onto each other, a young couple with their newborn, surrounded by friends and family were excitedly making their way to the door: the beginning of a new life. We smiled, simply, at the circle of life.

Image courtesy of Wikipedia.

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