This is what happened. I took a pain shot for Mrs. Diest into Room 23A and she was dead. No whoosh, no screaming for help, and no witness but God. I looked at her, sure she was dead, and all I could think was, “Did I do something wrong? Should I call a code?”

She had lung cancer that had metastasized to her spine, liver, abdomen — everywhere except her brain. She was aware and alert and could feel it all. When I would come into the room, she’d ask me if I would help her die; she couldn’t go on this way. In those days, a patient would have to wait three hours between pain shots. It seems archaic now, when people can have a continuous morphine drip during their last days, and even go home and give it to themselves through their catheter.

Mrs. Diest was a skinny lady with unequal spots of fine gray hair that had grown in after her chemotherapy had ended. The pain kept her in a fetal bundle most of the time, and when she began to be incontinent she would cry in humiliation and apologize as we cleaned her buttocks and changed her linen. We’d pull one side of the dirty sheet toward her, then roll her onto a clean sheet, the only way to change the sheets for someone bedridden. I would think of the cancer in her spine being smashed around her vertebrae as we turned her over, and she’d say, “I’m so sorry. I’m so sorry.”

She was in the hospital over the Christmas holidays. Her two grown daughters lived in opposite directions from the hospital, one an hour away, the other an hour and a half. They made irregular, short visits and a lot of excuses. Her husband of thirty-eight years had died a few years earlier, and she spoke of him all the time — of their home, the sailboat they’d enjoyed on Lake St. Clair, the raising of their children. She’d start crying when she spoke of him. I would get impatient, needing to go on with my work, check on an IV, collect a urine sample. I’d stay and listen, but would always feel myself drift away to gaze at a shiny side rail or a wrinkle in her sheet. I’d straighten the sheet, move her water glass an inch or two closer.

One day, in the middle of one of her stories, as I fingered the assignment sheet in my pocket, she stopped talking and looked at me. “Why, this is boring. You’re a busy gal. Run along now.”

I left the room in a hurry. I didn’t want her to see the flush of guilt sweeping up the back of my neck to my cheeks. She hadn’t been telling such a long story, I realized. I shouldn’t have been so restless. But I just didn’t have time to help people die.

That evening I went to Frank’s Nursery to look for a Christmas tree. The guilt was hanging on, the way an unhappy child clings to a tired mother. While I was there, my heart started a scary pounding, and I had to sit down in fear I might faint. That’s when I had the idea to get Mrs. Diest a tree. I thought of how happy she would be; she could decorate it with some of my old ornaments. So I bought a tiny Scotch pine, about three feet high.

When I got home my husband asked if I had found any good-looking trees. No, I said, no good trees at Frank’s. How could I explain it to him? What’s more, how could I explain it at the hospital, where live trees weren’t even allowed? It would not work. I carried the pine to a closet in the garage and threw it in.

I worked the day of Christmas Eve and put on my best nurse’s face with Mrs. Diest, as if nothing had happened. She said she was tired and just wanted to sleep, so I left her alone.

Weeks went by, and she didn’t ask me to help her die anymore. Sometimes, though, she would talk about something funny that had happened to her, or I would tell her about some exasperating thing my three-year-old daughter had done, and she’d tell me about something her daughters had done at that age. As she grew weaker and was in even more pain, her family couldn’t bear it and visited only on the weekends. Yet she wasn’t crabby, and she held out her good nature to everyone.

I’d drag myself to her room when it was time for her pain shots. It was difficult to be in the room any longer than necessary. Then I took her a pain shot one day in early February, and she was dead.


A few months later my husband went into the garage closet to put away the burlap we’d wrapped around our rhododendrons for the winter. He came to me in the front yard where I was cleaning up leaves.

“What’s this?” He held up the tree. The needles were a pale greenish brown, though few had fallen off.

“Oh, I forgot all about that. Someone gave it to me at Christmas as a joke. I guess you should throw it in the garbage.”

He shrugged. “OK.”

I was in Toronto last weekend and visited a friend who does bodywork. She told me about one of her clients who is dying. She said that she feels intense dread all the way to the hospital, but when she enters his room a feeling of peace and timelessness takes over. Since leaving nursing I’ve read about experiences like hers, knowing there must be a better way than what I constantly witnessed and participated in.

Then she asked me, “Did that happen a lot to you when you took care of someone who was dying?”

I dug my fingernails into my palms. “Yeah, something like that.”