Crozet Annals of Medicine: Small Gifts

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We have denture storage containers in all the major resuscitation rooms in the ER. We routinely run out of life-saving medicines but the denture cases are always there. Whoever is in charge of stocking them is on the ball.

We use the denture cases frequently for our sickest patients. Just before we place a patient on a breathing tube and ventilator we remove their dentures if they have them and it is nice to have a place to store them. We use them for other things as well.

She was 51 years old and healthy. Her husband heard her breathing funny in the marital bed. He thought she was having a bad dream. He couldn’t get her to wake up. He discovered that she had no pulse. Their home-from-college daughter began CPR and called 911.

Fifty-one is young for a cardiac arrest, and we work them pretty hard. We worked this one hard, but it was no use. I brought the family in while CPR was still ongoing and they said goodbye. I quietly called time of death for the team and then informed the family that she had died.

The family retreated to the quiet room to await other family members and the family priest’s arrival. I went to discuss organ donation with the family. I asked her nurse to accompany me. These can be difficult discussions and a team approach is helpful.

Her nurse was young, a recent nursing school grad only a few years out. I felt like this would be a good opportunity for her to gain some experience in this stressful part of our practice. I hoped the family would not be put off by her spiky hair, or her many tattoos and piercings. It’s a millennial thing, I guess.

I went through the organ donation discussion with her husband and answered the usual questions. “What happened to her?”

“She had a heart attack.”

“Did she suffer?”

“No.”

“Was there anything we could have done differently?”

“No.”

The husband was stoic and talked to us with a subdued but calm affect, sitting hunched forward in his chair. I admired his composure but mostly I was grateful for it making my job easier. I ran out of things to say and started to plan my retreat from the room. He seemed grateful for my silence.

Into the awkward stiffness of the moment the young nurse advanced. She stepped forward and swiftly knelt before the bereft husband. She extended both hands out, placing a small box into his hands. An offering. A denture case.

“I thought you would want this,” she said.

He opened the plastic box and a tear trickled down his cheek.

“Thank you. It was the only thing she was wearing,” he said in a choked voice.

She rose, hugged him, and turned and left. I followed her, in awe of her grace and dignity.

“What was in the box, Hannah?” I asked her.

“Her wedding rings,” she said simply.

“Oh.”

You can’t teach this stuff. 

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