Photo credit: Connie Gayer
Unplugged
by Tracey Delaplain, MD
The cold bitter coffee had lost its comforting appeal hours ago. I swallowed the dregs anyway and swirled the remains absently.
Was it possible to read coffee grounds like tea leaves?
Keeping my distance, yet hungry for answers, I searched the bottom of the stained and rippled paper cup. So tired, raw, empty but still I sit vigil.
Penance? Perhaps. What if? Why this kid?
Why not?
The ventilator bellows wheezed the last breath.
Empty questions, for in the end, I had pulled the plug myself.
Crumpled and spent, I tossed the cup and noted the time of death.
For more flash fiction hosted by Rochelle Wisoff-Fields go here. Feel free to leave your critique. Your comments are welcome.
What's for dinner, Doc? 
Sad story. Well done narration.
I’m assuming the MC is a doctor and not a parent.
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Could be either but I was trying to convey the protective detachment that allows a physician or a nurse to do their job. Of course the barrier is a facade. I’ve cried many tears alone in the stairwells and chapel of the hospital.
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Powerful š
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Thank you Helen.
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Ouch! Your words conveyed the pain you must often feel and the demons you keep at bay. I like where you went with this – Unplugged.
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Thank you. That’s exactly what I was trying to convey: distracting herself with a paper cut to keep the real emotions contained.
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Great take on the prompt Tracey… sad that it is based on true experience.
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Thank you Courtney
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Dear Tracey,
These types of stories are your utmost, gut-wrenching best. You can tell them like no one else because you’ve lived them.
My only nit-pick-crit is ‘I had pulled the plug’…I think it would be stronger if you lose ‘had’.
Stellar piece.
Shalom,
Rochelle
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I see that. I did struggle at bit with tense on this piece. Thank you. It’s my privledge to be able share my experiences.
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exposure to death and dying is so routine to folks in the medical professions that one may think they have become immune to it. obviously, it’s not. sad story.
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True, we just keep moving and reflect on it later. I was trying to convey a pause in this doctor’s long night sitting vigil with her grief close to the surface.
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sadness is often times expressed as a distanced irony.
Randy
what exactly was the time of death?
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I agree Randy. TOD? Probably 3 am. Everything bad happens at 3 am in a hospital.
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This one hits too close for comfort for me, having unplugged my husband almost one year ago and my father almost three… well, not me personally, of course. I could very well imagine that his how the inhalation therapists felt.
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I’m sorry Dale. I keep doing that to you. As you know my grief has been overwhelming this year. I don’t know if writing helps or not. I do know that I have been on every side of this scenario.
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No, don’t be! It’s all good. I truly believe writing helps. I cannot imagine being the one who physically does the pulling. It cannot get easier (and, I imagine, one would not want it to).
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Life never makes these choices easy. Good story.
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I don’t believe the physician in this narrative was lamenting the act of turning off the vent. but she was reflecting on everything before that point. Kids aren’t suppose to die which always leaves us wondering, “Why?”
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Ahh, thanks for clearing that up.
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I agree with Rochelle about the tense there. And it’s a powerful story that should be told. I don’t know how you do the job that you do. Well done.
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Thank you Sandra for taking the time to comment. I replied to CE about the “had”. I would be curious to know if you think it makes more sense with the additional information and did I trust my readers too much. I struggle with that when I write medical narrative. Your critique will always be welcome.
Tracey
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I read the additional info and I’d understood that once the ventilator was unplugged life would continue for a short while. I think it’s the link between the two statements: ‘the ventilator bellows wheezed the last breath’ and ‘I had pulled the plug myself’. That made me think that the ventilator had kept on after the plug had been pulled. So I’d either have added another ‘had’ – ie the ventilator bellows had… etc or miss it out on both. I get the feeling I’m not explaining myself very well here.
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I understand. The second “had” feels right as a solution when I look only at those two sentences. Very thought provoking and will make me look more closely in future pieces.
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It has all been said already, Tracey.
A terrific piece of writing superbly depicting the heartache of life.
And, reluctant as I am to disagree with the two giants of FF above, I think that the reflective nature of your tale means that the ‘had’ needs to be there.
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Thank you. I didn’t change “had” because you are right. The story is in the present tense but the ventilator was turned off before the patient died (past tense) and that is what she is reflecting upon. The confusion comes because most people believe that a patient dies immediately after the ventilator is turned off, which is not usually the case. There is a quiet time between turning everything off and the final heart beat. This is the time that I documented. I welcome the critique because I had to think this through on my own.
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Gripping. I like how you’ve used the coffee cup – a little piece of everyday life, a trivial thing, contrasting so well with the life and death decisions the doctor has to make.
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Yes that’s it. The cup is also a metaphor for entropy. Everything and everyone will degrade over time. Thank you for the thoughtful comment. I love when someone sees my thoughts.
Tracey
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“…the bottom of the stained and rippled paper cup. So tired, raw, empty but still I sit vigil….crumpled and spent…” Powerful words, powerful story here.
Just meandered to your site and read your story…and thought I would share two things here, that might be of interest. Living across the street from Mass General’s campus, we recently attended a wonderful talk about Physician’s Narratives — writing for healing of the healer — fascinating. And now I am connected with your words here.
Also, I think you’d find it interesting to read Dr. Johanna Riesel’s winning essay in the December 19, 2014 Lancet, entitled Looking for Rose. She lives just down the hall from us (highrise condo building) and….I’m Rose.
So nice to meet you again this morning….I appreciated your comment on my FF tale as well.
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Thank you Lillian. Writing is healing for me. My sister died this year in an ICU so writing about it has helped. I will check out the Lancet article.
Tracey
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I’m so sorry to hear of your loss.
I do believe writing is healing for many. As an MD, think you will find the Lancet essay very interesting.
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A gut wrenching passage. Extremely well written. I felt I was right there in the room.
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Thank you Russell.
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That detachment so much needed is so well described in that single mentioning of “noting” the time of death… to me that conveys the most… I understand so well how it has to be around having to live through death.
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Detachment is difficult for me. There are definite rituals around death, like calling the time of death that help with closure I think. Thank you Bjorn.
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Oh my gosh, so sad! That mesmerising look into a coffee cup for answers! Well written
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Thank you. I’ve yet to find any answers at the bottom of a coffee cup but I keep trying.
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C – Such a tragic scene. Swallowing the the bitter dregs of coffee is a fabulous metaphor for her feelings and what she had to do. It made the scene more poignant. The “Why not.” part makes me wonder though. It makes the doctor seem more callous than I originally picture here. The other thing is, I feel like this is the doctor’s patient, yes? Are doctors allowed to pull the plug? Should this be a family member that does the deed? Just my concerns. And in the finish the “ventilator bellows wheezed the last breath,” is another terrific metaphor. Fabulous work!
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Your comments are so appreciated. I’m fascinated by the concept of “why me?” We all say it and wonder why a tragedy happens to us, but “Why not you?”, “Why not me?” “Who then should it happen to?” That was my personal belief coming through. If there’s family then they can be asked to make a decision about turning off the life support but if there’s no family and the patient is essentially dead on the ventilator then a physician would make the call and in essence “pull the plug”. In truth the respiratory therapist would likely turn it off with an order from the MD. Pulling the plug was symbolic for making the final decision. Thank you for making me think about my work and your comments will always be welcome.
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Sad and powerful. Doctors are supposed to keep a professional detachment but I’m sure I wouldn’t be able to if I were a medical doctor, and I expect most can’t, at least not always.
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Ali,
There’s a fine line between necessary detachment and callousness. I’m sure I had more than a few callous days when I worked 80 hours a week. I have the luxury of time and reflection now.
Tracey
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Reading the piece and some of the comments, I realise how tough it must be for medics at times. I thought the tossing aside of the coffee cup was very powerful.
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The cup was definitely meant as a metaphor for life.
Thanks Patrick
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It’s wonderful that you can write from your work life. I thought that I would have many stories to write after over 30 years of nursing. But I’m surprised to find myself not wanting to go there. I can’t even bear watching that show on CBC on keeping Canada alive.
Lily
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Is Canada dying? Just kidding.
You probably have great stories to tell Lily. Their are some great books written about Medical Narrative. Thanks for stopping by, Tracey
I hope Canada lives. š
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I so wanted to unlike this. No one likes death. I’ve spent most of my life and my career around death, and the feelings never change. It’s never easy. Hugs and understanding.
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Yes, we need a “hate the subject but you’re ok” button. Thanks for stopping by and commenting. Why are you around death, if I may ask? You don’t have to answer.
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Oh man Tracey this was gripping. I loved the paragraph about the coffee and the feelings that evoked. Good job and a nice extension of the prompt.
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Thank you Joseph. The imagery really worked in this piece.
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It truly did.
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Perfectly crafted reflection, I liked how you told that story ‘around the coffee cup’. The cold, bitter coffee in the beginning created the right mood. Very powerful writing.
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Thank you. Now if I could only apply myself to NaNoWriMo and commit the energy to a novel. I’m falling behind. š¦
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What a difficult situation. Nice wriitng! I see you’re doing NaNo. Good luck. I did once. Just keep going and don’t edit a thing!
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Very good piece, the anxiety and the pain of the narrator is well written. It can be obvious what is the right thing to, but that doesn’t make it in an way easy.
There is a slight ambiguity whether it is relative or doctor narrating, but that doesn’t really matter. If it is a doctor, it captures the humanity of the profession, if it is a relative, it captures the love required to pull the plug (whether literally or by instruction). Either way, this is powerful writing.
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Thank you. I thought “why this kid?” would clarify the question about the narrator but a mother might ask “why this kid over another” but that seems like it adds another layer of complexity and remorse. As always, the reader has to be trusted to decide so you’re right, it doesn’t really matter. I appreciate the chance to analysts my work. Please come again.
Tracey
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Or maybe a parent would ask “why my child?” but the story doesn’t lose any of its power whoever the narrator is.
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Powerful. The coffee cup is an apt metaphor…tired…empty…crumpled…spent. Well done.
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I’ve felt that way many times in my career, as if there’s nothing left of me to give or receive. Thankfully those days were few and far between after I finished residency. Thanks for reading Jan.
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Thank you for sharing this experience with us. It has to be a wrenching one. I even cry sometimes at sad things on TV let alone an experience like this. Well written, Tracy. —- Suzanne
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Believe me Suzzanne, I cry at movies, weddings, funerals, and books all the time.
Tracey
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I like the way you used the coffee cup to convey the emotions of the doctor.
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I’m glad it worked. Thanks Dawn.
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