Letters from an ICU Nurse: Johnny

I sat, heavy with emotional weight, staring at the stiff, corpse, of my 35-year-old patient. I met Johnny exactly one week before his death. He was a southern good ol’ boy who was a sergeant in the United States Air Force. His infectious smile coupled with his charming drawl and sparkly eyes created an irresistible magnetism. Even though he was so sick he had to pause mid-sentence to catch his breath while speaking, his zest for life was inherent.

Upon meeting Johnny for the first time in the ICU, he questioned me intently about my personal life. This did not bother me and is one of the greatest privileges of my job as an ICU nurse. In an outside world overcome by political fluff and superficiality, the ICU leaves no room for small talk. It is an entanglement of constant raw emotion and vulnerability, which is a reality typically not experienced by the general public.

“You married?” He asked.

“Divorced,” I said. “You?”

“I had a wife once, maybe twice, and have a seven-year old son from a one-night stand,” he told me, “…best mistakes of my life.” I chuckled.

“Boyfriend?” He asked.

“Well, kind of, but I’m pretty sure it’s going to end tonight,” I said.

“Uh-oh, that doesn’t sound good. What’s the story?” He said.

“You don’t want to hear about my boring love life,” I said.

“No, I really do.” Johnny insisted.

At this point, I felt awkward sulking about my relationship to a gravely ill man, but I’m fairly certain Johnny was questioning me to distract himself from his critical state. The work of a nurse is to know a person holistically. So, while I was monitoring and treating Johnny’s physiological abnormalities, I was also interested in understanding the Johnny who existed before his illness. By conversing, not only was I diverting his mind, but also I was examining his body language and facial expressions, as any slight change in these may indicate a decline in his condition. So, naturally, I enlightened Johnny.

I met Sam out of nowhere, like a typical rom-com romance. He was a shorter drink of water to my five foot eleven inches. His blond hair and kind, blue eyes resembled a wholesome Midwesterner, but his boat shoes sans socks and unwavering confidence were a product of the East coast. In the months to follow, I would learn that Sam was intelligent, quirky, caring, wise, giving, affectionate and original. His logic balanced my emotional side and his introvert balanced my extrovert. He validated me, made me feel capable and beautiful, and made me want to be a better person.

We had our first date on December 23rd and consecutive days to follow. Sam was Jewish and did not celebrate Christmas; I was an ICU nurse who was scheduled to work and would be celebrating Christmas completely alone in a foreign city, six months post divorce, if it weren’t for meeting Sam. During our almost five month dating intensive, we saw each other nearly every day and became unexpectedly and extremely close. Sam gave me the opportunity to receive love without condition and the feeling was utterly transformative.

One of our last nights together, I knew we were nearing the end. I had received one of my first acceptance letters to graduate school, but had not mentioned it to Sam. I couldn’t be the person to end it. That night, I lay on his chest with my eyes wide open and my mind circling. I stared at every part of him and locked him in my memory. Every wrinkle, freckle, twitch, curve, the shape of his lips and the feeling of his skin touching mine was concrete; I never felt so close to another person. Our breathing was in perfect synchrony and so were our heartbeats. I focused intently on the rhythm of blood pumping through our bodies. Whatever this enigma was that I experienced, our souls had affected each other and nothing would ever change that fact.

“So, you mistakenly fell in love and now you’re moving across the country, I get it,” Johnny said.

“Yea, I guess I did, and I think I am,” I said.

“An old case of having the right person at the wrong time. And you know, only fools try to control love, you really don’t get to choose. Just let it be and take it for what it was worth. A real connection is rare, so embrace it,” Johnny said.

I knew Johnny was right. The end of my shift was nearing and I was headed to meet Sam. However, I was scheduled to return in the morning to care for Johnny again, so he wished me luck and told me he looked forward to hearing about it.

Sam greeted me with a rehearsed politeness and a lukewarm hug, but I was still overtaken with the sight of him. During dinner I spoke, but felt as if I was out of my body, watching two people on an awkward first date. I sighed an inkling of relief when the dinner was over, but dreaded the conversation ahead.

The exchange between us was robotic. We hashed out every scenario and talked in circles for hours. If we had been together longer, maybe we would consider a long distance relationship. I was rationalizing in any way I could. I offered to attend online school and do travel nursing so I could take contracts wherever he was living. “We both know you don’t want to do that,” Sam said.

He was always logical and was right in this situation. I did not have the strength to set myself free, so he did it for me. Underneath my extreme sadness and conflict, I felt an inkling of relief. He would not hold me back for the sake of himself or guilt me into staying. He let me go because he knew it was best for both of us. Essentially it was a battle of brain versus heart, and the brain won this match.

I walked in to work after a sleepless night with heavy eyes and a heavier heart. Johnny greeted me. “So, how was it kid? Did you two love birds have the big talk?” He said.

He was excited to hear my story, but I instantly sensed an over enthusiasm cloaking his failing health. The sparkle in his eyes was wavering and he was gasping for breath. He was now completely bedridden and dependent upon a significant amount of supplemental oxygen. The surgeon informed Johnny and his family that due to his declining condition, surgery would have to be performed the following day. Johnny had a 31% chance of survival. For the rest of the day I maintained Johnny’s physical comfort with medications and his mental comfort with conversation.

Per Johnny’s request, I Googled the state law and we created a will to disperse his belongings just in case. His brother and I signed as witnesses. Then, Johnny made three phone calls. The first was to his son’s mother who would be bringing his son by later in the day, the second was to his best friend, and the final call was to a woman I did not know. The tone of his voice was different with her; I sensed a new softness and longing. Toward the end of the call, I caught a glimpse of tears welling in his eyes.

I stayed after my shift to talk to Johnny. “There is a strong possibility that I may die tomorrow, but I’m really fine with that,” Johnny said, thinking aloud. “I’m going to fight like hell, but I’ve lived a great life. I’ve said everything I want to say to all of the people I love; most people don’t get to do that.” I gave him a tight hug and told him I would see him when I returned after the weekend. He said he was sure he would see me then too.

However, when I arrived back to work three days later, Johnny was non-responsive and multiple organs were failing. The sparkle in his eyes was gone as if his soul had already lifted. His family opted to withdrawal care. I turned off his vasoactive medications and he flat lined in seven minutes. His family said their goodbyes and left me with him.

As I disconnected the IV drips from his body, took out the endotracheal tube, and bathed Johnny before putting him in a body bag his words resonated with me. Something in my head actually told me that if Johnny made it, my relationship would make it. I was desperate. But, as Johnny reminded me the week before, I had to embrace what I was given and let it be. This love was not in my control.

The influx of emotions practically asphyxiated me, forcing me to sit down and stare blankly at Johnny. Behind my empty gaze was an alternating photo flipbook of every memory with Sam and Johnny; my mind was begging to formulate some kind of sense. Then, a knock on the door interrupted my thought process and a teary-eyed, woman appeared.

“I can’t believe he’s gone.” She said with her hands cupped over her mouth.

I did not have to ask her who she was. I stood up and led her to Johnny’s bedside reassuring her she could touch him. She held his cold hand within the warmth of hers.

“I really loved him, but it was just never the right time.” I nodded as I fought my emotions.

It was then I realized, in the scheme of things, we simply don’t get all the answers. I will never know why Johnny died so young or why people who deeply care for each other sometimes do not work out. Furthermore, even if reason transpires, it does not always entertain an elaborate and dramatic story, it just is what it is. So maybe had I met Sam in different time or place in my life, our relationship would have worked. But then again, maybe we would have reassuringly glanced at each other, as if we were friends in another lifetime, and merely carried on with our days.