As a nursing student I came face to face with the realities of life and death and suffering early on. The events of that week are forever etched in my mind. It was my second clinical rotation and I was in Med-Surg where I was assigned to a middle aged black woman. She was a round woman with wandering eyes and a kind heart. She gladly accepted this student as her personal care giver for the week. Her diagnosis was Myasthenia gravis.

Myasthenia gravis is a neuromuscular disease which is characterized by weakness of muscles such as the arms or legs as well as double vision, ptosis, difficulty with speech, swallowing, and breathing. The muscles that control breathing become too weak to do their jobs and crisis can occur.

She was a short, round woman. Her swirling eyes never met mine, but the smile in her heart was evident from the moment I met her. She was so fatigued she could barely lift her arms. Getting out of bed was exhausting and was not performed independently. She was assigned to the bed next to the window where the sun was ascending and the room seemed to swell with each audible breath she took.

One of my assignments was to obtain a lengthy health history. This took hours as she required frequent breaks secondary to fatigue and shortness of breath. She literally had to choose whether to talk or to breathe. One always took precedence over the other. I learned she had been diagnosed several years before, but had once again landed in the hospital with another crisis. We spent a great deal of time with one another as is the luxury of nursing school. I think she enjoyed my company, but most of our time spent visiting was riddled with concern for her future, her distress, and frustration with her illness.

When meal time came, she had no energy left for which to eat. She could not operate her jaws, breath and hold her arms up to the tray all at once. I offered to help feed her, but her pride was too big. She was exhausted and ready to give up. With great effort, she took the pillow from behind her head and heaved her arms up and handed it to me. She looked directly at me and asked me to end her suffering once and for all.

This young nurse was paralyzed with fear. Did she really just ask me to suffocate her? I was scared; so scared. I had no experience. The only thing that came to my mind was my training regarding the art of holistic nursing. With that thought I simply asked her if I could pray for her. She smiled and nodded. I said a simple prayer, more for me than anything, and then my shift was over.

I met with my instructor briefly and told her of my day. She was proud of me; for what I did not know. The next day it was to begin again.

The next morning, I entered the hospital with trepidation. I was afraid; afraid of the unknown, afraid she might not be with us any longer. I entered our report room where we were to leave our books, gather our things and headed out on our assignments. I lingered in this room much longer than was expected. Eventually I began the long walk down the hall to her room.

I hesitated at the door, gently knocked and waited. Nothing. I pushed on the door slightly and heard the room breath that audible breath. The sun was streaming in the windows and the round woman with the swirling eyes smiled at me again.