One drop at a time.

Cold icicles that hang over the roof appeared as though my house was weeping. So were all the plants out side of my home.

As much as I enjoyed seeing the beautifully sculpted icy art pieces, something left me with a bit of sadness reminding me of those moments that I wished that my tears would freeze.

A preventable series of errors left my father brain dead and it led to subsequent death. It was interesting to find an article on Mortality, Morbidity section of the Agency of Health Care Research and Qualify website today that depicts a case reminiscent of my father's case. Except that this case described how the patient was resuscitated successfully thanks to the emergency bedside tracheostomy. That was a luxury my father was not provided for even though he begged for it before he lost his consciousness, due mostly to the inadequately prepared physician on call. He had no idea that someone who could not perform this tracheostomy would be on call the night he endured 8 hour surgery. He had no idea that nurse who could not recognize drain malfunction would be taking care of him. The series of misfortune and lack of attention or lack of knowledge was incredibly shocking that it almost drove me mad. I had never known that feeling before or after that event in my life either. Faith was not enough, I almost said. I don't know why I kept my sanity, i know it was grace, which was sufficient for me at that time. But in a practical sense, probably because I was the only person in my family who truly understood what occurred, or failed to occur medically speaking and I was the only one who could deal with it. Yes, the team initially attempted to divert out attention from their short comings to other issues that most ordinary people would agree to. They thought, I was just a nurse. In japan, there is no Nurse Practitioners so they did not know that I actually understood far more than they thought I did in terms of what my father's blood gas values meant (in relation to the events that occurred) or what the amount of inotropics suggested or the difference in the HCT immediate before the surgery and after the event, etc...... I was grateful that I could be a good detective. I can not tell you how rewarding it was that I could present my case of what I believed happened (of failed to happen) with sufficient data pointing out to the cause of his condition. My brother, although extremely bright, and my mother, also sufficiently informed could not understand the detail and I decided to leave it alone. It was too painful for any human being to live with the visual image on how one thing to led to another. Having been an ICU nurse at Johns Hopkins dealing with various surgical patients in the past, or in CCU in other institutions, I have certain sense of what nurses should consider as potential risk of your own patients. I could not believe how poorly trained the nurses were, let alone the physicians were.

I felt, and I still say this without hesitation, I almost thought I was in a third world country.

Evaluating the labs results, CT, and performing my own neuro assessment on my father was strange at the least,,,I proceeded with almost peculiar calmness, and it almost felt as though I was observing myself from outside of me. That is the best that i can describe.

It was an experience that required the utmost patience, forgiveness, tact, and self control against incredible wave of anger, guilt, devastation and uncertainty.

Freezing rain that left frozen tear drops around my home reminded me of how far I have journeyed mentally and emotionally since the day when my heart froze as my father's heart placed its last period on the monitor screen. As I left Japan behind after successfully negotiating to allow peaceful end for my father, tears filled my heart and eyes. (Now, the experience of negotiating on medical ethics issue in Japan is completely another subject that I would one day have to revisit) My mind was flooded with the image of my father's agony. Many questions remained and investigation continued for a long time. Was it God's goodness that led me to this profession so that I could understand fully what went wrong or what failed to happen? I have come a long way in the few years but I still can not listen to the song, "Danny Boy" without remembering the ground I left my father's remains and the intense emotion that drowned my soul as I separated myself away from the quiet ground. The grave and its area is now hushed with blanket of soft white snow waiting for the spring to return. The spring would have the magic to thaw the ground and it would bring back blooming flowers and singing birds. I know my pain may not completely thaw away, but I do not mourn as one who is without hope, or who is without the great comforter who can understand grief. I can continue to devote my energy for the loved ones who remain here with me. Moving onward.

I know, one day I would awake to a new place where there is no more tears. But for now, as long as I am here with my beautiful family and friends, tears are real.

My Great Friend is able to wipe away tears, one drop at a time.