On September 27, 2019 over half a million people gathered on the streets of Montréal to demand urgent climate action. A few days later I stood petrified in front of a mannequin and a hysterical Italian Canadian woman pounding the plastic chest of her crash test dummy husband in his last moments of “life.” These two events are indelibly wired on the same synapse of my memory. My nursing cohort gathered in the same strange subterranean patient stimulation classroom conveniently located in a labyrinthine underground stripmall reminiscent of stale fried chicken and industrial bathroom sanitizer. We fiddled with our stethoscopes and shuffled in our white tennis shoes many of which still bore splattered paint stains from protest signs lettered the days before. We waited for an attendant, clipboard in hand, to direct us to our stations craning our necks down a long wood-paneled corridor. We tried to recognize which paid actors we had worked with before and bet on which would pose as our simulated patients in the tiny examination rooms which shook beneath the weight of passing semi-trucks on the streets above. Montréal offered no shortage of talented actors out of work to choose from. To them it was a few hours of (ostensibly) pleasant work barring the assignments requiring 25 girls with long fingernails blindly palpating for their large intestines. To us these simulation days represented our only dress rehearsal to test drive our fledgling clinical responses being dispatched to the front lines of Québec’s public health crisis.
These 2 days are tethered together in my mind.
Most people prefer to think about what they will eat for breakfast first thing in the morning as opposed to their ultimate mortality. I believe that this is one of the driving factors of the climate change crisis as well as the core neurosis of our health system. On September 27 2019 in an unprecedented reversal of human nature half a million of us woke up and thought about pounding the pavement in response to global inaction in the face of a dwindling carbon budget and the need to get our shit together or face runaway climate change and its implied annihilation. When I walked into that room I was expecting to offer generic grief counseling to a distraught wife. I was expecting the easy patient simulation scenario that didn’t require complex memorization of protocol and procedure. What I was faced with was anything but easy. There is a moment in the grieving process that defies language expressed in the kinds of sounds one only hears in hard un-medicated childbirth or despair. When somebody has a DNR posted clearly above their headboard yet their loved one is shrieking at you to do something. When someone about to lose the love of their life is incapable of anything short of imploding as a super nova collapses upon itself foreshadowing the black hole of years of grief ahead. Her wailing left me awash in a sort of sudden existential paralysis. I was being watched by an evaluator and my peers and had to do something. I took out my stethoscope as she screamed at me to do something and listened to the lungs, inspected the blue fingers, assured her that the sounds of a death rattle was a normal finding at the end of life in order to FOR THE LOVE OF GOD DO SOMETHING!!!!!... Her hysteria grew more intense and cataclysmic buffeting my eardrums with hurricane force. I held on to her hand.
I should have called in a senior nurse from the hallway sooner. My colleague knew what to do. She knew to stroke the woman's back the way we instinctually do with our children when they awaken frightened after a bad dream. It suddenly became okay to do the only thing that a rational person would do: to let someone scream, and cry and wail. To fully allow the heartbreak. The felt catastrophe of our imagined control over life unraveling in our hands. The stillness and silence that hums in our happiness and stifles in our sorrow. It was only then that she could hear us. “Your husband can probably still hear you.. Hearing is the last sense to go…” My colleague said.
"He needs your love right now." I said. "Tell him everything that you need to say because he needs your love right now.” As she unraveled down to a whimper an anonymous intercom voice signaled the scenario’s end. Nothing about it had felt fake. The actress dried the tears on her cheeks and smiled. I did a good job on being compassionate, calling for help, calming her down she said. Yet there was one thing I didn't do: I couldn't say that he was dying bluntly and to the point. I couldn't speak the words. I couldn’t answer her repeated question, “IS HE DYING?!?!?!” I don’t think I even heard it over her cries for action and the pressure I placed on myself to perform. My paralysis was visible.
The signs at the climate march were sobering: "you will die of old age and we will die of climate change." Read one. The cries for action were overwhelming and coming from all sides. None of it was wrong. Yet it required a first step which nobody was discussing either in nursing school or the world at large. To recognize that that which we love is mortal and one day we will part with it. That nothing is permanent. That we will even have to part with our most cherished dreams someday. It requires unthinkable strength to stand in the face of all that is mortal in cherish it knowing that it too will pass. Perhaps we offer the world the depth of love that it needs to hear only in those moments of absolute surrender—when we know it's our only option. I have been wracking my brain for months trying to think through an existential framework from which I could navigate the questions of living in an age of unprecedented dying. Our world is not a dress rehearsal. It is a code blue and we need all hands on deck. Yet if we are to survive with our heart intact amidst all the frenetic action that our generation must effect for the sake of our survival it can't be with the same canned language of hope for change. Hope was the last thing in Pandora's box for a reason: it can too easily scaffold the myth of infinite growth and humanity’s heralded upward climb as dominator of all species. It can too easily lift us up only to drop us on the concrete of cynicism. At the risk of sounding ridiculous I think that only love can fill that resounding grief that is tearing at our collective psyche hinged on the edge of our power to act and sense of powerlessness. That force that allows us to stay and bear witness a wife becoming a widow in an uncomfortably convincing patient scenario or the real thing outside our window. The simple reverberation the love that takes refuge in our bodies and is released in the moments when we are most fully ourselves. Like many of life’s greatest victories or micro-milestones of progress the difference between heartfulness and pantomiming its equivalent is known only to ourselves: unmeasurable and un-evaluate-able. Simply being. It is that which I am looking for, finding and losing it, breath by breath.
Brenda Cleary
B.A French Literature, B.Sc. Health Sciences, M.Sc. Nursing Science
Brenda.cleary [at] mail.mcgill.ca
Ingram School of Nursing, McGill University