"You can't feed a person who's on a ventilator. The machine's pressure forces the stomach contents out and up, and the fluid gets into the lungs. It's called aspiration. The patient can die." Jill's cheeks puffed out as she exhaled. It was hard enough being an outsider in this family; it was frustrating to be both a nurse and an outsider trying to instruct these country folks on the finer points of patient care.
"It doesn't seem right though, not to feed her. She hasn't had a bite to eat for a month now. How can she live?" Mike blew his cigarette smoke through a crack in the window. The wind propelled the noxious fumes back inside the car. Jill coughed and cut her eyes at him.
"Well, the doctor should have her on a feeding tube. That'll take care of her nutritional requirements." Jill smiled, hopeful the issue would be settled with that pearl of wisdom.
At the house, Mike's cousin Miranda met them at the door. Before long the hunger issue was broached again.
"But she's got to be hungry, Jill. We can't just leave her like that to starve. That little bit of gruel we put down that tube won't help her get her strength back." Miranda looked hopeful. She stood, toying with the hem of her sweater.
"She's fine, I promise. She's getting everything she needs from the liquid feeding."
Miranda sighed. "Well, thank you for coming to visit. I know Aunt Donna will appreciate seeing you."
Jill walked to the old woman's bedside. The rhythmic whoosh of the ventilator was the only sound in the room. A thin line of ocher-colored urine in the catheter bag hanging from the side rail caught Jill's eye.
"How long since that bag's been emptied?"
"Oh, a day or two," Miranda replied. "Why?"
"That's not enough urine for that length of time. She may be in renal failure." Miranda's forehead wrinkles deepened.
"Oh, my." Tears welled up in Miranda's eyes. "That means --"
"Does her doctor know about this?"
"I ain't sure, Jill."
Jill finished her cursory examination and joined the rest of her husband's family members in the parlor.
"I think Aunt Donna's very close to death. You should concentrate on making her comfortable now. That's about all you can do."
Uncle John looked accusingly at Jill as if she'd caused Aunt Donna's condition rather than defining it. "You damned nurses and doctors. You put folks through hell with all these tubes and things, then starve `em to death." He stamped out of the room. A moment later the front door slammed.
"Come on, sweetheart. We're going back to the motel, everybody. Our trip's about worn us out."
Jill and her husband left the house. No one stepped forward to hug them; no one even said goodbye.
* * *
In the morning they made the six-mile drive up Wolf Bend Hollow to Uncle John's and Aunt Donna's ancient log house.
"There's a lot of cars here, Jill. Wonder why?"
"I see that. Wouldn't be surprised if Aunt Donna passed away in the night and no one called us."
Jill was right; the old woman had crossed the veil, as the family put it.
"How'd she go?" Jill's husband asked.
Miranda stepped forward. A gentle smile crossed her weathered face. "It was like this, you see. I just couldn't let her starve to death. You know how Aunt Donna loved her biscuits and gravy? I made her a mess of `em and cut them biscuits into itty-bitty pieces. Then I soaked `em in the gravy `til they was soft as oatmeal. It took me `bout an hour, but I fed her every bit of a soup bowl full. Why, she coughed a time or two and I'd slow down, but `fore you know it, she'd eaten every bite." Miranda sighed, her pleasure evident.
"She had passed on when I checked on her next. She had the most peaceful expression on her face that you ever saw."