AFRAID TO DIE

I was in the cardiologist’s office as a student nurse practitioner with my nurse practitioner preceptor John. There were two nurse practitioners and one cardiologist in this busy office. They were in the process of looking for another cardiologist. John was very knowledgeable about cardiology. It was his love and his first job after graduating four years ago. I wished I could be that lucky once I graduated.

John and I split his patients where he would see one and I would see the other. Once I get the history and examination done, I would go out to the hallway and tell him my findings. I needed to have several differential diagnoses, treatment plans, medication or lifestyle adjustment teaching, follow-up…etc. He was tough but I learned.

It was almost noon on a Monday. I had seen seven patients. I am still terribly slow but I know I will pick up speed as I get more experience and establish my comfort at this level of nursing. There was one more patient to see before the office closed for lunch. I picked up the chart and started to go through it. In the exam room was an 87-year-old female who was in the office today for her 6 month follow-up appointment to check her new pacemaker. She had the pacemaker placed 6 months ago. Her name was Mrs. Alice Williamson. The nurse had already done a pacemaker check with the manufacturer’s machine and all of the numbers looked good. I knocked on the door before entering. Seated next to the wall was an elderly woman who looked in pretty good health. She did not have a cane or a walker next to her. She looked pretty good considering the length of her medical history. I introduced myself as a nurse practitioner student and shook her hand. I told her I would be getting her history and perform an examination. Mrs. Williamson did not mind talking with me. I started with routine questions to establish how she was feeling and doing overall. She told me she was doing fine and had no complaints. I went over her medication list to make sure she was still taking them and if she needed any refills. She did not. Everything was going well. I had her stand and walk to the exam table to see how stable she was. She was slow to get up but she was able to walk without any stability problems. I did my exam by listening to her heart and lungs, listened for bruits, felt all of her pulses, looked at her skin color and her feet. I was done with my exam. I had her sit back in the chair next to the wall. I pulled up the stool next to her. I sat on the stool and told her everything looked fine. Then I noticed she was starting to cry. I asked her what was wrong. Alice told me, “I am afraid to die.” I asked her why she was feeling that way to see if something had happened recently that scared her. She told me most of her long-time friends have already died. She lost her brother last year in another state and her husband five years ago. I grabbed the box of Kleenex off the counter. Alice then asked me if she could fly on an airplane with a pacemaker. I told her she could fly on an airplane. This started her talking about why she was afraid to die.

Alice mentioned her great granddaughter Amy who lived in Boston. She wanted to see her very badly but was afraid to fly. She told me Amy probably will not be able to come out to see her because she was busy with college. I asked her why she was afraid to fly on an airplane. Alice told me her brother had a pacemaker and flew to Chicago last year. The first day he was there he apparently died from cardiac arrest. He did not die on the airplane but in the hotel he was staying. She was scared to fly because she did not want to die like her brother. But she did not want to die before seeing her great granddaughter. Alice was still crying.

I took her hand and told her she should go see her great granddaughter in Boston. She should not be afraid to fly. She shook her head yes. She was doing very well medically. Her heart had a new pacemaker which tested perfect today. Alice had stopped crying. I sat with her for a little while longer. Alice told me she would call Amy this week to see when she should fly to Boston. I told her she would have a very nice time in Boston with Amy.

I got up from the stool to talk to John about Alice. He came into the room to briefly see her. Alice was not crying anymore and had a smile on her face. Alice was told by John her pacemaker looked good. She would need to make another appointment 6 months from now. Also, she needed to go to Boston to visit her great granddaughter. Alice smiled. She slowly got up. John and I both shook her hand and led her to the desk to make her appointment. It did not matter the 15 minute appointment turned into 45 minutes. Alice needed to talk to somebody about her fear.

I stood there a while and thought how people stereotype the elderly population. Many assume if people had lived into their 70’s, 80’s, and 90’s, they were satisfied with their lives and should be ready to die. Why shouldn’t an elderly person be just as afraid to die as somebody in their 30’s or 40’s? There was nothing wrong with being an 87-year-old female who was afraid to die. Is this not a natural fear no matter what the age? I was grateful I met Alice that day.