Godspeed, My Friend

It’s a brilliant January morning; the kind that earns California its nickname “Golden.” Feeling the warmth, it's hard to believe the rest of the country is in the grip of a monster blizzard. I park in the staff lot on the west end of campus (of all my emerita benefits, free parking is the best!) and walk up Welch Road.   Just as I turn up Pasteur, the whump-whump-whump of LifeFlight sounds overhead.  I glance up, a little thrill coursing through me.  Whenever a helicopter flies overhead, wherever I am, I look up to see if it’s one of ours.  I love that whump-whump-whump sound.  It means somebody is getting the help they need.

Today the person getting help—the one I am headed to see—is my neighbor.  His brain tumor diagnosis came almost exactly two years ago, so he has already beaten the life expectancy odds.  But he took a bad turn a few days ago, developing a lung infection peculiar to chemotherapy patients.  Transported to Stanford’s ICU, he had a series of mini strokes and is now intubated.  He won’t be able to communicate.  I want to see him, nonetheless, one more time. 

I could use my old badge, sail past the welcome desk of the New Stanford Hospital and make my way to the fourth floor.  But I’m not supposed to, so I don’t.  I check in with a lovely young woman who asks: Do you need directions?  I don’t tell her that I have conducted numerous tours of this building, demonstrating to donors what their support has accomplished.  I assure her I can find my way. 

Walking to the elevators I pass the massive granite wall that dominates the lobby floor. Looking up, I silently recite the words I know by heart: “Striving to restore health, enhance life, and drive the future of biomedical discovery, we gratefully acknowledge the generous donors who supported the Campaign for Stanford Medicine, helped construct this hospital, and created an enduring legacy of hope and healing.”

Another little thrill.  These words—my words—have stood the test of time, I think.  Short and simple; they will endure until this building comes down.  Of the places across this campus where I was tasked with creating monument language, this is the showiest.  Once when my boys were little, I showed them such a wall, this one over in the sports complex.  I wrote that, I told Cooper, who was around six at the time. He looked up, wide-eyed, and asked: Did you have to wait til after dark?   After dark? I asked, confused.  Then I got it.  He was imagining me sneaking in at night with a ladder and a chisel, committing vandalism --- for what purpose? To make sure I got published somewhere?    

On the fourth floor, I make my way to M4, mask up, and check in with a nurse who walks me to my friend's ICU room.  The first thing I see, entering the room, is sunlight streaming through the oversize windows, reaching across the floor to the patient bed.  A memory of a long-ago conversation pops up.  I was in a meeting with the design team, who were discussing how to create an ICU that felt more like a home than a hospital.  Natural light would be essential, said one of the clinical staff --- for the patients receiving care; for the loved ones fighting anxiety; for the medical staff who worked such long hard hours in this place.  This conversation took place maybe 15 years ago.  I look at the sunlight streaming across the room and bathing my friend's unconscious body.  Mission accomplished, I think.

Nobody knows what an intubated, sedated patient hears. But the accepted practice is to speak anyway.  So I do, telling my friend what my time with him has meant to me.  How he left a legacy of beauty in the world with his art.  How he brought together our neighbors around the mission of helping him.  What I don’t say aloud, but think silently, to this solitary, sometimes prickly man: I hope you saw in us an example of how most people are good.  How you don’t have to be suspicious or cynical.  How, given half a chance, most humans wish each other well and will go out of their way to help. 

I stroke his arm, willing him to feel my touch.  The rhythm on his heart monitor is so weak, so irregular, that it is clear: he is very near the end.

Will others be coming? the attending physician asks me.  She means: will others be coming to say goodbye?  How hard should we work to keep his heart pumping for a little while longer?

I am not his medical power of attorney I answer carefully.  So I don’t have any legal standing here. But it’s clear what’s going on.  I'm pretty certain nobody else will be coming, I tell her. 

My friend has a wonderful, devoted caregiver who has spent many hours at his bedside. But he has no family close by.  No real friends.  The neighbors were kindness personified. But they might find it difficult to be in the presence of a person who looks like this. Being in these settings sometimes triggers me a little, putting me in mind of my own losses.  But by and large I am comfortable here.  What happens in these places matters.  And from the beginning of this journey with my neighbor, I have been determined that he would not die alone.

Thanks, nods the attending.  That helps. We have pretty much maxed out on the meds we can give him.

Because I seem to know a lot about what’s going on, the staff asks if I am a medical professional.  Nope, I say. Just a medical writer.  I had a hand in getting this hospital built. After I say this, what follows are some wonderful conversations with the doctors, nurses, techs, and myriad others who flow through an ICU room.

I hear a torrent of gratitude.  They love working here.  It’s the best place they’ve ever been.  They cannot imagine ever leaving.  They can’t believe how people they have never met so carefully and accurately imagined their needs. They appreciate the hundreds of details that make this place the best possible blend of technology and humanity -- another one of my lines, used to promote the project.

I am filled up.  Watching a life end.  Hearing how our work of so long ago is still touching lives.  Feeling a human connection that seems, in this moment, sacred. 

Do you want some time alone with him? asks the ICU nurse.   No, I answer.  You can hear what I have to say.  And your job is hard enough without having to dodge around me. 

After about an hour, I know it is time to leave. I stand and ask him:  Remember all those conversations we had about life, death, God, religion, what comes next, who had it right? The Christians, the Buddhists, the atheists?  Who? Well, you get to find out first, my friend.   Whenever you are ready, go for it.  I wish him peace and light and godspeed and walk out of the room. 

On my way down, I stop on three--the Garden Floor—to look at the beautiful art, so carefully curated to evoke healing; and the gorgeous rooftop gardens, so soothing to people who are having the worst day of their lives.  So many hours we talked about these things; wondered, debated. It is an expensive way to build a hospital. How on earth are we going to pay for it? we asked. Is it worth it? 

This day I have the answer.   Yes.  It was worth it.  It will continue to be worth it for as long as this building stands, and people come here needing what it has to offer.

Days like this do not happen to me all that often.  Not all this light, dark, memory, loss, pride, hope, humanity.  Not all together and not all at once.  Today, for me, they did.  A symphony; perfectly balanced, and beautiful. 

I walk down the grand staircase to the lobby, take a final look at the wall, thanking every last donor on it. I make my way out into the brilliant sunshine, find my car, and drive home. 

About a half hour later, the text comes in.  My friend has died.