Suit & Tie

Cristine
Jul 14, 2024
5 min read

Mr. Z was the most gentle soul I had ever met. Having moved to Canada in recent years with his wife from China, he worked as an accountant until the lower back pain started. The discomfort was followed by difficulties in walking, unintentional weight loss and fatigue. It was then discovered the Mr. Z had advanced stage lung cancer with metastatic spinal cord compression, a condition considered as an oncological emergency due to the irreversible damage it can cause if not treated in a timely manner. Mr. Z had several tumors impinging on his spine requiring emergency radiotherapy treatments to shrink the cancerous masses and alleviate the debilitating symptoms we would shortly notice as the weeks went on.

Mr. Z was a man in his forties who possessed an extremely positive outlook on life. As one of our doctors said (and this is meant as a compliment, for all you politely correct people out there), he had a "dumb f*ck smile" that made it so much more difficult to deliver bad news to him. Throughout his hospitalization, his wife was at his bedside on a daily basis. They were a couple who seemed to never get upset or angry towards anyone or each other. They always smiled when staff would enter the room and expressed gratitude at any given opportunity. It was impossible to leave his side without hearing the words "thank you".

After several weeks of treatment, Mr. Z's symptoms began to worsen. Given his fragility and an extremely unstable spinal cord, he was not a candidate for surgery. Not only did he have progressive leg weakness and paralysis, he started developing weakness in his upper extremities as well. He particularly had reduced mobility to his wrists making his hands dangle and interfering with his ability to hold objects. At the beginning of these physical limitations, Mr. Z would take the medication cup from our hands clumsily to take his prescribed pills. However, as his weakness became increasingly debilitating, he no longer had the strength to lift his arms off of the bed. Yet, despite such loss of autonomy, Mr. Z was still smiling from ear to ear. He still thanked the patient attendants for feeding and washing him. He still thanked the nurses for giving him pain medications and injections. He still thanked the doctors for coming by to update him on his health condition. He still thanked everyone even if he was told that he, unfortunately, wasn't getting better.

Mr. Z then went on to develop dysphagia and loss of sphincter control. In layman terms, it meant that Mr. Z had difficulty swallowing and was unable to voluntarily pee or poop. Given that he was bedridden for a long period of time, it is no surprise that constipation kicked in. Despite the use of all the laxatives, suppositories and enemas, Mr. Z was unable to have a bowel movement. With increasing pain in his abdomen, it was time to use the last resort. I will omit the details of the intervention, but just know that it is very VERY unpleasant. I can still hear the screams of agony as we tried to relieve his problem. Although such "task" took no longer than half an hour, hearing the pain of the man with the "smile" felt horrible. Once it was over, Mr. Z's discomfort was relieved ... and he still was thankful despite the uncomfortable ordeal.

Rapidly, Mr. Z's body was failing him. Despite being in bed, he was short of breath, talking less and sleeping more. He had developed pneumonia and had become so emaciated that it appeared that solely skin wrapped around his bones. As his time was nearing, the team was concerned for his wife's ability to cope. Being recent immigrants, his wife had mentioned that they did not have much social support in Canada. With both their parents back in China, the couple was adjusting to life as Canadians. What distraught the team the most was the fact that Mr. Z still had not announced to his parents of his cancer diagnosis.

Such news struck a chord, especially since most of the female colleagues I worked with were mothers themselves. When Mr. Z was capable of expressing himself, he had explained to them that he did not want to worry them, and he believed at the time that he was going to make it through. As he quickly deteriorated, my coworkers had convinced Mr. Z's wife to let her in-laws know what was going on. And so she did ...

One morning, as I looked at the assignment, I noticed that I will be taking care of Mr. Z with my nursing student. My nursing student, Z.D., had only started a few days ago and was learning the ropes of the unit. Since I had never had Mr. Z as my patient with her, Z.D. did not know Mr. Z as the rest of the nurses did. We sat down at the nursing station and began to take report from the night shift nurses.

"5310, Mr. Z. sadly passed away not too long ago. I believe he drew his last breath while he and his wife were on a video call with his parents in China. His wife is still in the room with him."

My heart shattered into pieces. I became distracted and required extra effort to concentrate for the rest of morning report. Once done, I got up and headed to room 5310; a wooden door with the dove sign stuck to it. On our oncology unit, such poster indicated the death of a patient. I paced back and forth in front of the door, gathering my thoughts, anticipating how I would feel, shed a few tears and finally gathered my strength to knock on the door. As I opened it, I saw Mrs. Z's wife sitting near him teary-eyed. I shared my condolences with her, reminisced about the kind of person he was and gave her a big hug. She wasn't accustomed to the process after the end of life (funeral planning and clerical affairs). After all, the death of a loved one is the last thing we would want to have experience with. As we guided her through the process and referred to the social worker, she had one simple and honorable request for us.

"Would it be possible to dress him up in his clothes prior to sending his body off?"

"Absolutely"

Before complete rigor mortis could set in, we urged Mr. Z's wife to get his clothes as soon as possible and that we would wait for her to return before wrapping him. An hour later, she came back. As we opened the bag, we noticed she had brought him a white long sleeve polo shirt, a dark navy suit and a black tie. Although his body had become somewhat rigid, my nursing student, Mr. Z's wife and I were able to get him into the dashing outfit. Mr. Z laid on the hospital bed looking like the gentleman he always was. "Please take care of my husband", said his wife before leaving the unit. "We will", I genuinely replied to her.