AFTER DEATH, WHAT?

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This is not a philosophical question, or a religious one. It’s a question about what happens to the person sitting by a hospital bedside when the occupant of the bed, someone who was loved and cherished, becomes (suddenly or at last) “the deceased,” dies perhaps even while the sun is still shining brightly through the clean hospital windows, mocking the dark ache in the heart of the solitary survivor.

In the hospital where Bill died early in May, a four-year-old state-of-the-art hospital in upscale Princeton, New Jersey — home of a world-renowned university, of the Institute for Advanced Studies (where Albert Einstein found safe harbor after fleeing anti-Semitism in Europe during World War II), and of Westminister Choir College, whose graduates grace stages in many celebrated opera houses – in this spiffy new hospital, the person blinded by tears who holds the still-warm hand of a new cadaver simply ceases to exist.

A nurse’s aide came to wheel away the equipment that had sustained Bill’s life for the past seven days. I began to gather up my things, thinking they were about to clear the room. “You can stay for half an hour or so,” she said matter-of-factly as she left. “They won’t take him away and remake the bed before that.” People continued to walk back and forth in the hall. I had to get up to close the door.

Not that I had counted for much in the hospital before that, except as a conduit for conveying important information about Bill. In fact, “you can stay for half an hour or so” was one of only five things anyone there said to me the day Bill died. Earlier, Bill’s fourth pulmonologist had come by to report he wasn’t getting better and what did we want to do next, whereupon I told her Bill’s son and I agreed we should let him go. She nodded and said, “I wish more families were as wise as you.” And that was that. She just left. I never again saw or heard from her, although it was me who had accompanied Bill on every outpatient appointment with her and asked at least half the questions. It was also me who had brought him to her office in a wheelchair just before she checked him into the hospital because he was so weak and sick. She knew me. I had thought she was nice. But of course I wasn’t her patient. Her role as a physician ended with Bill’s death. She had no obligation to me, not even a human one. Not even to say she was so sorry.

Somewhat later, another pulmonologist came in. I had seen him briefly just once before, because he was one of four in practice together who took turns doing the hospital rounds for pulmonology cases, so that each was there only every fourth day and you never really got to know any one of them. (Maybe that’s how they keep from becoming too emotionally invested in a patient.) “You’d better notify a funeral director to come get the body afterwards,” he said. “We can only keep it overnight.” As if Bill were a left-behind package needing removal.

After they pulled out the intubation tubes and — still unconscious — Bill was rapidly slipping away, an intensive care nurse came to check that dying was proceeding properly and reprimanded me for looking at the monitor to see his oxygen level. “Don’t look there. Look at his face,” she scolded. (While I still could?) She turned off the monitor. So it was me who first noticed he had died. I held my hand against his cracked and slightly open lips but no faint breath came out. She brought in the pulmonologist who had advised calling a funeral director. He held Bill’s inert wrist for a moment, looked at the clock, and said — not to me, but to the nurse, who was taking notes — “Time of death 2:52 p.m.”

When he, the nurse, the nurse’s aide, and the equipment were gone, I called the funeral director and made arrangements to come to his office next day to pay him for what he was about to do and give him the requisite information for the death certificate. Then I kissed the forehead of the body in the bed that wasn’t Bill any more and stumbled out of the room into the hall and towards the elevator. It was a long hall. I had trouble maintaining my balance. The resident who had seen me every day for the past seven days was at the floor reception desk as I passed him. I gave him a slight nod, but not a flicker of recognition crossed his face. He might have been staring into space. I also crossed paths with the two day nurses and one of the four pulmonologists who had looked after Bill during the seven days he spent in their care. All three looked right through me.

One person noticed how erratically I was walking. It was the respiratory technician, a woman called Antonia who appeared to be in her late fifties; she had been in Bill’s room every day during the last three days of his life to adjust the respirator keeping him alive. Our eyes met, she came towards me and held out her arms. It was a big hug. My eyes began to fill again. “Will you be all right driving home?” she asked, still hugging. I nodded, because it was too hard to speak. “Be careful,” she said. “God bless.”

Of course I wasn’t all right driving home. My hands and arms shook so much I could hardly keep the wheel from going out of control as I tried to make the winding turns out of the hospital complex and back onto Route 1 South. Two other drivers gave me long and frightening honks, as if it were thanks only to them I myself had narrowly escaped being killed.

Resigning myself to the fact of Bill’s death is still very hard. But what particularly festered on the day he died, and does to a certain extent even now, is that his doctors and nurses made it so very clear they didn’t care at all about what I might be feeling. Maybe where there’s so much pain and suffering for their patients, they can’t permit themselves the humanity to be even momentarily concerned with those who survive the patients. Or maybe my experience was unique. Maybe at other hospitals it’s different. I don’t know. All I can say is that nearly three months later, I don’t remember the names of any of the four pulmonologists or the intensive care nurses. I’ll remember Antonia with gratitude for a very long time.