PALL CARE

Here is an example from the author’s experience with an extended Filipino family: The dominating sound, overcoming gunfire coming from the T.V., is the 40-in-a-minute rasping, gurgling breaths from the emaciated shrunken occupant of the bed. I touched this family patriarch tentatively, as family members ranging from toddlers to young adults gathered around the bed. They had placed a Crucifix in his hands. His pupils were fixed, one midpoint and one constricted. His lips were cracked and his tongue covered with brown-red debris. With and without a stethoscope, his lungs were overcome with wheezing and crackles. His heart was regular at 124, but failing to move the blood all the way into the periphery. His feet and legs were icy purple without pulses. Maybe 100 cc of thick dark brown urine sat stagnant in the bag hanging from the side of the bed. Until today, they had been giving him liquids like orange juice, which it sounded like he was unable to swallow, so that it went right into his lungs and led to fits of coughing. He was without any signs of suffering. I reviewed basic care measures with the oldest son, particularly care of his mouth and lips, turning, and how to use morphine under the  tongue if he had any signs of distress with breathing. I talked about hearing being the last sense to be lost before dying. Death appeared imminent, so I urged them to say their good-byes and pray together. Hearing my prediction, the family decided to call the priest.