The Exchange...

The Exchange Cyndi S. Schatzman My feet hurt and I was ready to go home. Discouragement filled me as I helplessly watched my favorite ICU patient, Mr. Nunley, slowly slipping away. His old flabby heart was failing him by the minute, and time was running out for a transplant. I gazed into the dimly lit room and said a hushed good-bye to his daughters, assuring them that I would be back tomorrow. We exchanged forced smiles of fading hope. As I prepared to leave, my head nurse came up to me and asked if I would like to go watch a heart transplant: Mr. Nunley’s! I ran back into his room to share the good news. Hope and sadness filled his eyes as I told him that I was going to another local hospital to observe the harvesting of his new heart and then come back for his transplant. I hugged his daughters and called my husband to let him know I wouldn’t be coming home until late. The organ donor was a gentleman in his thirties who wasn’t wearing a helmet when his motorcycle crashed. This father of three small children was giving one last gift of life to five or six other people before the machines were turned off. I choked back tears as I pondered his wife and children. How would she tell them that Daddy would never be coming home again? I marveled at her courage to share the life of her loved one with others. As we entered the OR, a beautiful but beastly thought kept invading my mind: today one must die in order for another to live. That is when I looked up and saw her. The nurse on the other end of this story shuffled into the OR with bloodshot, tired eyes that spoke volumes. She came in and out of the operating room to provide updates to the donor’s grieving family. With awkwardness, the two of us talked about the families. We each knew what our purpose was on that day. Her role was to stand in the gap for the grieving family. She took on grief and passed on hope as she hugged them. My role was to stand in the gap for Mr. Nunley’s family. I passed on the joy and absorbed their guilt through my support. She left the OR quietly and respectfully once his heart was removed and placed in the cooler. The heart was quickly escorted by ambulance to the surgical suite of Mr. Nunley. Artificial life support took over as the gray, oversized, flabby muscle was removed. I was overcome with fear and hope when, for a few minutes, his chest was completely empty. There was no turning back. Then, the new, firm, pink heart was presented and stitch by stitch it became one with Mr. Nunley’s body. We all held our breath and watched the EKG monitor as a defibrillator shock started his new life. Shouts of joy and victory rang out on this side of the exchange. I ran down the hall to the waiting room to share the news with his family. It was finished! Life prevailed even in the face of death. Tears flowed as they expressed gratitude for the donor and his family. A new life and new hope filled all of our eyes as the exchange of life was completed. As I drove home in the dark early-morning hours, I was overcome with emotion. I thought of the widowed wife, the grieving children alone in bed, and the nurse who became a stitch in their lives on the day that their hearts broke. Because of their pain and loss, my patient would have life and joy. Then I realized my purpose as a nurse even more clearly. Nurses stand in the gap, like the heart bypass machine, in the lives of their patients. One nurse may hold the hand of death, while another holds the hand of life. Our eyes tell their specific stories and our hugs uphold one another, and each day the exchange continues in the lives of nurses and their patients.