Tiger Katie - A Memoir

Slowly injecting Narcan into the y-site of her IV line, I am sitting on a folding chair beside her.  She lies on the bed, ballooned up with blood, edematous from internal hemorrhaging.  Skin so yellow she glows like a dandelion, skin so moist and beaded up with sweat.  Chestnut hair lies dry-damp upon her pillow.  Katie.  Tiger Katie.  Fought so hard - and she WON! 

No detectable cancer!  What incredible joy must have filled her after all the misery the prior year of treatments had caused.  Chemo, blocked stents, replaced stents.  She is a tigress.  Back to Alaska, rid herself of that dead beat husband and was making it on her own!  Cholangiocarcinoma – incurable. Cured.

Katie came down from Alaska to fight this battle.  Armed herself with the doctor who is a tiger and together…they fought. They won. 

“Please God; don’t let her die on my shift.  Keep her breathing 8 times a minute.”  That was my personal cut off for her – not nursing practice.  School says 10 times a minute – if breathing less you give Narcan.  Give her medicine to keep her breathing.  The medicine will reverse the narcotic which suppresses breathing.  The narcotic gone - pain.  The pain of stents in her racked liver and blood filling every gap in her tissue; expanding beyond.  Billowing her up.

I look at the clock, give a quarter of a dose, count, count, count…….count, count…count, count, and count.  Eight breaths.  I stay beside her.  Her mother went to get something to eat in the cafeteria.  I watch, I pray.  She needs to keep breathing until her mother changes her mind.

Her heart.  It was all about her mother’s heart.  Katie had been dying for a couple weeks, but a few days ago lost consciousness.  She lost her tiger growl.  Now mama has to step in.  She calls the shots as her daughter fills with the sanguine life.  Katie’s body can’t clot off properly.  Too much damage.  Too much chemo. 

How does a mother decide it is okay to say, “No more.  Let her go?”  It is the right thing to do, but how a mother doubts.  How a mother second-guesses every tiny decision in regards to her babies.  And you ask her to say “Stop!” 

Why hasn’t that doctor talked to mama tiger?  Doesn’t she understand there is no reversal now?  Why are we all here?  Why has this happened?

For if she dies, I am required to push upon her fluid filled chest.  We are required to make her last breaths violent – bloody.  We are supposed to completely reverse her pain control; crowd in a room of staff and medical students…mama tiger would be pushed into the hall.  Without mama's permission to NOT DO THIS THING we are left without option.  Is this a better way for her to die than in a quiet room with a mama by her side?  Holding her hand, stroking her hair, wiping down her beaded forehead with a cool cloth?

Six breaths.  A “whiff” of Narcan.  Not too much or it’s gonna make Katie wince.  My folding chair vigil.  “Keep her breathing, Lord.  Help her mama say it is OKAY.  It is okay to let her baby go.”  How can a mother let her baby go?