Amazing Grace
by Ray Fowler, MD
Copyright Jan 1, 1988

(Time in Space Home)

            Awhile back, a memory was created for me that even now brings pause for reflection.

            Dusk had reluctantly bowed to advancing darkness, and early evening congestion busied the admitting clerks in the emergency waiting room. The radio crackled, “General Hospital, this is Rescue 12. We are enroute to your facility with a fifty year-old man with difficulty breathing. He is confused, with very weak pulses. He has terminal lung cancer.”

            Such a case led me to hesitate: Terminal cancer, expected to die, now in shock and gasping for breath. “Rescue 12,” I replied, “Assist ventilation with oxygen, suction the airway, evaluate constantly, and transport.”

            The stricken man arrived a few minutes later, clearly dying, with glassy eyes, feeble pulses, lips drawn over bared teeth.

            “Mr. Jones,” I asked, “Can you hear me?” He blinked painfully in reply, too weak to respond verbally. The daughter, a mature, husky blonde, relayed to me the events of the last few weeks: Increasing home health care, terrible pain, gradual inability to swallow, now gasping for breath for two days.

            “He wanted to die at home, but we just couldn’t take it no more watching him suffer,” she said. A moment later she went on, “Doc, he didn’t want no tubes in his throat. He wanted to go peaceful.”

            I led the daughter, the wife, and a grandchild of teen years outside the examination room. “In a few moments, Mr. Jones will die,” I said. “I can do various things that may support him for a day or so, but this will require tubes in his throat, IV’s, and many tests. And, it won’t help him. He is so near the end now, I think we should all go in and sit with him and just be near to him for his last few minutes.”

            The family conferred for a moment. “That’s what we were praying for, Doc,” whispered the daughter. “These last few weeks, all we could hope for was that he could finally be at peace, he’s been sick so long.”

            We returned to Mr. Jones, who was now staring dazedly up at the ceiling. His pulse had slowed and was very erratic. Slowly his eyes met those of his wife, who was now standing by his side, holding his hand. His daughter and grandchild completed the circle around the bed, I remaining at his head to suction his airway lest he choke on thick secretions.

            "He always liked to hear ‘Amazing Grace'," said the wife.

            "Why don’t you sing it for him,” I said softly. Her voice was so full of tears that she could only murmur a cracked weep. Then, her daughter began to sing, her own voice shaking and stumbling:

            "Amazing grace, how sweet the sound…”

            Mr. Jones visibly relaxed, his lids settling a fraction. All leaned toward him, all eyes fixed on his.

            "That saved a wretch like me…”

            The wife, gripping his hand tighter, said, “Go on, honey, go be with Jesus.” The pulse slowed, and the breathing became easier, more shallow.

            "I once was lost, but now I’m found…”

            Mr. Jones began to stare upward, and a haziness covered his eyes. The pulse only occasionally flickered, only a wisp of air moved into his lungs. “Go on, honey, go be with Jesus,” she said again.

            "Was blind, but now I see,” the daughter murmured.

            All was still and quiet for what seemed a very long time. Mr. Jones’ eyes were fixed in infinity, his heart stilled. We remained standing around the stretcher awhile longer. After a bit, I pressed his lids down and placed my hand over the wife’s hand, saying “I’ll be right outside if you need me.”

            Closing the door after myself, I headed for the little office where I go to cry privately when my heart strings get strummed. “Sometimes,” I think, as I weep into my handkerchief, “this job just takes more out of me than I can stand. Who am I to pick a moment such as this to let a man die? Where is my authority? How did I know? Could I have been wrong?”

            And then, a trickle of a feeling from the recesses of my mind cooled my passion. All of us can only be what we are. In the great family of human brotherhood, the depth of our experiences mixed well with the sincere commitment to decency requires us to only do our best, while giving the greatest attention to care possible. In this reality is the strength to go on.

            I turned from my thoughts of the dying to go out and care for the living, through the long night that lay ahead.