A question I usually hate, not because I shy away from recounting Zack’s hospitalization and death, but because the fact that people ask it implies that there is any sort of justice in the universe. That there is a cause, or a reason, that this happened beyond random chance; any narrative that makes sense about it, anything to learn from it; that it’s even the part of the story that’s worth telling.
I realize they’re just asking “how could this happen?” but I’d literally rather tell you about how he organized his socks (a subject on which he had Opinions) than have you think the manner of his death is anything but the least important thing to remember about him.
All that being said, I’m finally writing it in brief because the first thing I want to know when I flail around on the internet looking for writing I can empathize with, looking to know I’m not alone, is what the hell kind of Widow Creds does this person have. It’s not about how their spouse died but about the widow’s narrative. Can I relate to their situation? So, all 0.3 readers of mine, here’s the backstory.
Zack was hospitalized for suspected pneumonia in June 2018, one month shy of our 9-year wedding anniversary. He died after a week in the MICU at Albany Med.
He was my best friend since freshman year of college, 16 years ago. He had congenital heart and lung issues that didn’t stop him from delighting in life and resiliently handling everything it threw at him. We were the world to each other and devastated doesn’t begin to describe how I feel now. Being prepared for the unlikeliness of having many retirement years together didn’t make me prepared for him to die when we were 34 and our son was 18 months old.
The weekend of Father’s Day he has what seems like a fever and mild illness with no particular cough or congestion, which leads to significant trouble breathing, which leads us to our primary care doctor who takes one look and sends us to the ER, where they admit him and start antibiotics and treat for severe ARDS. June 19, 2018 is the last time I see him conscious because they put him on mechanical ventilation.
There’s no clear inciting incident for the illness, though the doctors ask about anything that might guide treatment decisions, especially after cultures don’t help them narrow down the antibiotic choices much. I still think about it even though it’s unproductive. Was it some bacterium in his home oxygen tubing? His surgery in January? A dental cleaning?
For several days his vitals are up and down and I don’t really know enough to understand his prognosis and I read all the papers I can, so I can go over his labs with his nurse and ask intelligent questions in morning rounds, so I can understand what we’re facing. I still don’t let myself believe he’s not going to be in the 50%, or 30%, or 20% survival rate. Want to believe that because he’s been lucky every time he’s brushed shoulders with death that that means he’ll be lucky now. Just studiously ignoring the logical fallacy.
When people ask What Happened sometimes they mean “why didn’t he get better in the hospital?” Yeah, I don’t have an answer either.
The fact that he’s an interesting case means he’s been on a first-name basis with experts on his conditions and I’ve been calling directors for their recommendations and making sure they’re in touch with his doctors up here. I have met the attendings and the cardiology folks and the infectious disease experts here and done my best to prove to them that I am both intellectually capable of comprehending the jargon and emotionally capable of frankly discussing his condition. As if there’s some scrap of information I can offer that will improve a treatment decision; as if by force of will I can make the universe give him to me.
By the 22nd we’re looking at transport for ECMO. Ultimately, three institutions say no. He’s not a transplant candidate due to sepsis, and it’s a bridge therapy, not a destination. No one will start it if there’s no path to recovery. They try to start dialysis here as some last-ditch effort to keep the acidosis under control while we wait in vain for antibiotics to work. They prep him for it, but they can’t keep his blood pressure high enough. For some reason they shield me from the term “septic shock” and I don’t make them say it even though we all know that’s what they’re describing.
The evening is a blur. Doctors and nurses tell me when they’re leaving as we switch to the night staff. One kindly presses me to think about the fact that the default will still be for them to do CPR if his heart stops right now and I say I’m not ready to change that.
An hour or a few later, after they can’t get the dialysis started, I tell them shakingly but carefully, choosing my words precisely, “I would like to withdraw my request…”
I sign that part of the MOLST form and take some time to sit with his body as machines try to force it to work.
Then I sign the rest and they stop the pressors and under my hand, his heart stops beating.