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The End of the Exhale

By Gabrielle Elise Jimenez

“What happens at the end of the exhale?” That was the question posed by Frank Ostaseski, one of the leaders in end-of-life care, in a recent interview. The exhale he is referencing, is the one that happens after you take in a deep breath, hold it for a moment, and let it out all the way down to your toes.

COVID has made me feel like I have been holding my breath for a very long time. I am constantly waiting to exhale, without the fear of what might happen next, hovering over me. In early March I became very ill and regardless of my test coming back negative, even the doctors thought I had COVID. I spent weeks in bed, isolated from everyone I love, and everything I love to do, constantly imagining the worst. I had a window in my bedroom which was my only view of the outside world and I was scared. I was lonely. I cried almost every day, desperately forcing some sense of optimism in between the tears.

Once I recovered from being so sick, I was able to go back to work, which was both terrifying and heartbreaking, despite how happy I was to be back.

I am a hospice nurse and that in itself reminds me how fragile and precious life is. But doing this work during COVID, has taken what I do to a whole new level, one I was not prepared for. Once I recovered from being so sick, I was able to go back to work, which was both terrifying and heartbreaking, despite how happy I was to be back.

I had to learn a whole new way of providing end-of-life care to our patients who were dying, and comfort and support to the people who would say goodbye to them. I couldn’t hold their hand, I couldn’t hug them, and I couldn’t stay at their bedside until they took their last breath. Sometimes I wasn’t even allowed in the home, which meant that many times our patients died alone. This broke me, but it also lit my fire. I was determined to find a way to support our patients and families despite COVID.

I found other ways to keep families connected and to be able to provide human touch that was safe and effective. I realized that while skin-to-skin touch is far more powerful, it is the touch in general that provides comfort… even when there is a rubber glove in between you and them. I found that while in person is always better, hearing the voice of someone you love over the phone can bring comfort. I held a lot of phones up to a lot of ears.

Ripping off the N95 mask after each visit, looking in the mirror at the creases in my face, and desperately trying to breathe down my daily panic attacks from the claustrophobia has become routine. Every patient visit means applying another layer of PPE, but I look at it as the thing that allows me to see my patients and continue to do the work I love to do. So I deal with it. I have struggled, I have cried a lot, and I have had many moments of weakness when I honestly thought I couldn’t take it anymore. But I refuse to let COVID win.

COVID has made every attempt to destroy us, and while the statistics have my heart feeling ache and sadness, I have taken from this experience many lessons and for that I am thankful.

In between all of the news stories that bombard us daily, the glimpses of goodness brighten my days. My heart smiles when I hear stories of communities coming together, neighbors helping neighbors, and people finding ways to help the small local businesses even if they can’t actually go inside. I love seeing the signs on front lawns and in windows, and the banners thanking all of the essential workers. I think the word “hope” has taken on a more powerful meaning for most of us.

COVID has made every attempt to destroy us, and while the statistics have my heart feeling ache and sadness, I have taken from this experience many lessons and for that I am thankful. For one thing, it has helped me see how much I take for granted and how selfish I can be. Or how I sometimes rush through my day hurrying to get to the next, not truly enjoying what I have while I have it.

The pandemic has also changed the way I do things. To stay connected, I am now sending handwritten letters to friends and family. I check in with neighbors often, and I share a lot of baked goods. I will continue to do this even after COVID is gone not only because it brings me joy, but it also keeps me focused on what is important.

Life is unpredictable and COVID reminded us of that, which inspires me to stop putting off the things I have dreamt of doing, and actually do them.

It is easy to say there is nothing good about COVID, in fact, there is a whole lot we can say about how truly awful it is, but I believe that we will look back on this time and remember the lessons and the take-aways from it all. Life is unpredictable and COVID reminded us of that, which inspires me to stop putting off the things I have dreamt of doing, and actually do them. I walked a portion of the Camino a few years ago and have said I want to walk the whole thing one day. Now I say, I will walk the entire length of the Camino — and I WILL do it in 2021. After that, I will go to Bali, Thailand and India. If all we can be absolutely certain of is right this minute, wouldn’t it make sense to live it the best way we possibly can, and to embrace all the magic and wonder of it all?

What is at the end of my exhale? Relief, gratitude, appreciation, and hope for everything good that lies ahead, and I have a child-like excitement for it all.


About the Writer

Gabrielle Elise Jimenez, Bucket Age 28, is a hospice nurse. She hasn’t always been; she changed her life in her forties with the intention to specifically work in hospice. She continues to evolve in the area of end-of-life care, recently becoming an end-of-life doula. Her goal is to teach and inspire others to do this work, and to help change the fear and uncertainty that has a tendency to hover around death. Her belief is that education is key, and even if it just relieves the fear of one person sitting at the bedside of someone who is dying, that could make a difference for them. Working in this field has increased her appreciation for all of the magic and wonder life has to offer, and while she is present for a lot of death, what she really sees is love, faith, and in most cases, a life very well lived. She aspires to have a well-lived life and encourages those around her to do the same.

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Lori LoCicero
17 days ago

How truly inspirational. Both your beautiful essay and your life’s work. Thank you for all you do. May you find so much joy at the end of your exhale.

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