Personal History

So live, that when thy summons comes to join The innumerable caravan, which moves To that mysterious realm, where each shall take His chamber in the silent halls of death, Thou go not, like the quarry-slave at night, Scourged to his dungeon, but, sustained and soothed By an unfaltering trust, approach thy grave, Like one who wraps the drapery of his couch About him, and lies down to pleasant dreams. — —William Cullen Bryant, “Thanatopsis” I first met “Jane” when she “finally” agreed to accept a nasogastric tube at the tail end of my co-intern’s postcall day. This was just a few months into the year, before I knew to use scopolamine to quiet a death rattle, before I knew on a fundamental level that you don’t put a percutaneous gastrostomy tube in someone with days to live. Steve signed out at 7 pm after tracking me down in the nurses’ station. “I just can’t put in an NG tube now.” He dropped heavily into one of the swivel chairs, grimacing at the nighttime skyline visible from the fifth floor windows. “I’m beat. Do you mind?” I said I didn’t. “What’s it for?” “It’s freakish. She’s 45, been getting weaker, falling, slurred speech for a year , finally comes in to see a doctor 5 days ago and guess what, she has end-stage ALS. She’s in for a PEG and needs decompression with an NG tube overnight. She can barely manage any secretions. Oh, and she’s full code.” “Full?” I asked skeptically. “Why?” “Can’t let go,” Steve said. “Family heavily involved. I really have to go see my family for once. Thanks for doing the NG tube.” He rose and trudged off the ward. I went to see her shortly after. Her mother, brother, and sister sat on her bed …