Denise Napoli Long is a home hospice and emergency department RN and EMT with her local volunteer fire department.
“Stillborn, / or perhaps a baby who died / just after birth, I was never sure.” So writes Carol Scott-Conner in her poem “Baptism - Bellevue Hospital 1974,” published in the Spring 2023 issue of Intima. That’s the line, isn’t it, between what is medicine and what is holy: knowing. There is so much that is unknowable. At what moment did life begin, and at what did it end?
In my essay for the Spring 2023 issue “On Hope,” I recount how a doctor told me, “We are witnessing a miscarriage in progress.” It’s something I can’t forget, nearly a decade later: that I was close to the moment, that I was a witness—nearly. And it’s a vital bit of knowing for my hospice patients, too. They want to be there at the last breath, the last heartbeat. What does it mean for them to know the exact moment, I wonder? What would it have meant to me? And what could it have meant to Scott-Conner and the parents of that baby she baptized so many years ago?
Lately I have begun working in the emergency department in addition to my per-diem hospice gig. Ambulances come in with patients “found down.” They have been dead, technically, for who knows how long, of who knows what exactly. We go on anyway, giving it our best shot, starting lines, doing CPR, baptizing our patients (and ourselves) in their “spilled blood / and other sacred fluids,” as Scott-Conner writes. At some point the physician will call it. “Time of death,” she will say, and the number is recorded somewhere, registered, as if it’s gospel.
But gospel is mystery. And sometimes in medicine we must accept and consecrate mystery, much as we crave its opposite. Maybe we do it for our patients and for their families. And maybe we do it for ourselves: “I think I hoped that the baby / would start to breathe—it didn’t.”
There it is, again: hope. Hope is there in the not knowing, in the mystery of when exactly life is over, where being ends. Hope is where holiness is. We should embrace it, as the poet did. Then medicine is made divine.
Denise Napoli Long is a home hospice and emergency department RN and EMT with her local volunteer fire department. Napoli is also a former medical news journalist and a student in the MA in Writing program at Johns Hopkins. She is working on a longer manuscript about end-of-life care in the U.S.