The Goodbye Gift

Part One
6:30A.M.




The sticker on her chart read DNR. Do Not Resuscitate. Just three black letters on a red background signifying that a life was soon to end. Miranda felt her heart drop. Flipping through several pages, she scanned the previous shift's nursing notes on Mrs. Hurst.




11pm-7am "Patient's breathing was labored throughout the night. Dr. Wright notified and was in for assessment. DNR order signed and duly witnessed. Family contacted as per patient's request."



"Mrs. Hurst asked for a DNR?" Miranda directed her question to the day shift Charge Nurse sharing the break room with her.





"Yes, she seems convinced that she's not going to make it through this time," Joni replied as she completed the daily patient assignments and rose. " You know she's been fighting the lung cancer for a long time now. I think she's just too tired." She held out a piece of paper. "Here's your patient list. I assigned her to you again since you took care of her yesterday and the last time that she was admitted. Just make her comfortable and keep her company as much as you can until her family comes in. I gave you a light load today."





"But she shouldn't just give up," Miranda protested, automatically reaching for the proffered list. " I mean she was walking around on her own just yesterday. Have they tried everything? Maybe if they-"





"Nope. There's nothing left to be done," her co-worker interrupted in her usual matter-of-fact way. "She's going down hill quickly. I doubt that she will ever get out of bed again." Joni lumbered her stout body toward the hall. She stopped just short of leaving and turned, her expression softening at Miranda's stricken expression. "Honey I know that you're still new at this, but it'll get easier. Take my word for it. I've worked these floors for thirty years now. Well...at least the emotional part gets easier. But the physical...ugh my ankles are screaming for mercy and my feet are praying for retirement." Gesturing toward the coffeepot as she pushed out the door, she added, "Get yourself a cup of brew, but watch out Kara made it. I'll see you out on the floor."





"Grabbing a paper cup, Miranda poured herself a drink and slid into the chair just vacated by Joni. As she gazed out of the room's only window and watched the rising sun stretch it's weak rays across the hospital's parking garage, she wondered yet again if she had made the right career choice. Years ago, when she had first graduated high school, all Miranda wanted to do was attend nursing college. She had thought of nursing in a rosy light then, as a profession where she could use her outgoing personality and caring nature to make people well. But the money for her tuition hadn't been available at that time, and before she knew it, she had become swept up in a progression of marriage, children and menial jobs that never seemed to pay enough to cover the bills, let alone allow her to follow her dream.





Now here she was at the age of forty-six, with college several months behind her. The twins, Eric and Alec, had just turned twenty-five and were busy with their own lives. Ever opposites, Eric worked as an accountant while Alec was a graphic artist. Her husband Sal also seemed content with his job as a carpenter. Her whole family was healthy and doing well and she was finally a Registered Nurse. She should feel ecstatic. She should be on top of the world. Miranda took a sip of coffee, wrinkling her nose at its strength and sighed. She had never been more miserable.





It wasn't that she had still expected nursing to be glamorous when she had finally began the college program four years ago. Oh no. By then, over twenty years of reality had taken its toll on her rosy, teenage vision. Life was hard, and so was nursing. But for Miranda, unlike her co-worker Joni and most of the other nurses, the difficulty lay not in the long hours on her feet, the lifting that strained her back, or the health risks that faced her daily, but in the emotional drain. The simple fact was that Miranda cared too much. No matter how hard she tried, she just couldn't quite achieve the level of detachment about the patients that was her co-worker's saving grace.





Miranda had tried talking to Sal about it, but that was a dead end. Not that he was an uncaring man, but they finally had a solid second income and he was just beginning to enjoy the slight easing of their financial burden.





"Just do your job and come home," he would reply when she mentioned her difficulties adjusting to the emotional demands of her new profession. " Its great pay. Hell, this is the first time that we've had medical benefits in years. And remember we still have to pay off your student loans..."





As if I'm likely to forget, Miranda thought as she glanced at her watch, stood and poured the rest of the murky coffee down the sink. After smoothing down her navy blue scrubs and washing her hands, she caught a glimpse of her wavering reflection in the aluminum towel dispenser. Serious green eyes with the beginning of crow's feet, set into a heart shaped face stared back at her. When added to her curly, chestnut hair and 5'3" frame, these attributes had earned Miranda a lifetime of being called "cute." Normally she resented her pixie appearance, feeling that her looks prevented her from being taken seriously, but one glance at her current image with her hair pulled back into an unruly pony tail and blue, grey smudges still visible beneath the cover stick she had applied under her eyes and Miranda knew she had nothing to worry about. No one would call her cute today. She took a deep breath, finished drying her hands and tossed the towel away. It was time to begin her day. Mrs. Hurst and five other patients were waiting.