How Nights Are Pronounced
By: Henry Slone, MD
From time to time I come across words that are more commonly written than spoken. Maybe I decide to use one, or find myself struggling to sound it out. When is the last time you heard someone say naphthalene, or shibboleth? One example I have encountered is the word copse. It means “small collection of trees,” but no matter how many times I see it in writing, it never feels natural to say aloud. So, I have learned that it is words with an imbalance between the written and spoken take on an odd nature. When such words are heard instead of written, they sound entirely unfamiliar.
I first noticed the quiet when I walked into his room. It was unusual. I felt the change as I ducked in from a busy ward hallway. It was evening, and though things were beginning to settle down, it seemed too still. People do not exist silently – we innately make noise. It happens when our chests rise or when we swallow, when we squirm within our bed sheets, or when the fabric of clothes brushes against skin. Going into a room with even one other person is enough to generate an ambiance of presence. This was different.
I did not want to act as if this was out of the ordinary. It should have been another checkbox on a list of tasks in a busy shift. If I thought about it differently, I worried I would not be able to do it. No one else seemed to think this task meant much – preparation for it was rarely mentioned. Instead, it had to be just part of the job. I always assumed mastery of it would come with time and become something I learned by doing, so I ignored the twisting feeling in my chest and stepped forward.
As I did, I began to take in the rest of the room. I saw a few pieces of artwork done in crayon and watercolor with the smell of art supplies still fresh in the air. I also saw a translucent bag with clothes resting on the shelf, denoted simply as “Patient Belongings.” With that, I slowed down. I realized they were probably the clothes he came into the hospital with. I stopped. Through the window, I could just make out the fading dusk.
With my gloves on, I checked everywhere for evidence of a heartbeat, perhaps hidden under his still-warm skin. I counted the seconds until I reached thirty as I fumbled with the series of numbers. The whole thing felt stupid, like I was pretending. His chest stayed silent. Then I grabbed a light and shined it into a pair of eyes that refused to stay closed. I waited for anything. They stayed half open, and after that, I called it.
I tucked him in as if he were just sleeping, trying to occupy myself with the sheets. The silence in the room kept growing. I felt like I needed to say something but I didn’t know what.
“I hope you’re comfortable now, bud.”
I went into the hallway to tell both his nurse and the charge nurse. Our conversation contained a lot of words I never said before: time of death, decedent, pronounced. They sounded different out loud. Felt different when I said them. My mind flickered back to the word “copse.”
His nurse was new, not unlike me. She looked stunned. I wanted to say something, but I did not know how. There were more words I had not heard before. I realized hospice did not mean any of us were ready for what would come following entering this type of care.
They warned me nobody would come in to see him that night. Nobody did.
Some minutes later, I watched what was left of the sunset as smoke rose from a chimney into an empty sky.
Henry Slone is a second-year internal medicine resident at OHSU. He loves in no particular order: reading, running, and movies. He hopes to one day be an academic physician and is undecided on specialty (although he has, at times, described himself as “Cards curious”). Henry plans to continue writing regardless of his future specialty/career and hopes some pieces of his reflections can add something to the lives of others given life is about sharing things with others.
