THROUGH THE VALLEY | Caiwei
Is it the time?
A printed sign was taped at eye level, freshly posted and impossible to miss.
Comfort Measures Only.
I stood there longer than I meant to, reading the same line twice. The hallway lights hummed overhead. A cart rolled past. Someone laughed at the nurses’ station.
My hand rested on the handle. It felt cool.
I pushed the door open.
The room was dim. The blinds were drawn. Morning light stopped at the window, held back by the glass. The noninvasive ventilator sat unused against the wall. The high-flow oxygen machine still ran, its low hum steady but tired. A fan rotated in the corner, set to its highest speed, clicking softly at the end of each turn.
Everyone in the room was breathing. No one breathed steadily.
He lay flat on his back, eyes closed. The bridge of his nose was marked from days of pressure. His cheeks had hollowed. Stubble shadowed his jaw.
The monitor traced green waves across the screen. Oxygen saturation flickered in the low nineties, then high eighties, then back again.
Twenty days earlier he had arrived upright, speaking in full sentences. Now even turning his head required preparation.
IV medications hung in clear bags that emptied one after another. Steroids pushed through IV ports. Diuretics measured into small cups. Heated high-flow nasal cannula at full force.
One afternoon he agreed to the CPAP mask. He hesitated before it was placed. His hands hovered near the straps. Then he let them fall. The mask sealed. Air rushed in with steady pressure. His chest rose against it.
That night he slept seven uninterrupted hours. The next day we lowered the oxygen to fifty percent. Then forty. We stood at the bedside watching the numbers drift downward, waiting to see if they would hold.
He smiled when the saturation stayed above ninety. My gloved hand met his in something like a high-five. The plastic snapped softly.
Later, the numbers began to fall again.
A small shift of his shoulder would send the monitor into alarm. The sound was sharp, insistent. He would inhale carefully, deliberately, as though drawing air from a deep well. The tendons in his neck stood out. His abdomen tightened with each breath.
I stood beside him and watched the screen.
Seventy-nine.
Eighty-one.
Eighty-four.
I did not say the lowest numbers out loud.
When it climbed back, I leaned closer.
“Eighty-five… eighty-eight.”
He closed his eyes again, conserving what the effort had cost.
This went on for days.
Then, without warning, his wife died.
She had taken a bottle of pills the night before. There was a note on the kitchen table. The coffee cups were still in the sink. She wrote that she did not want him to go alone.
Later that afternoon, when the alarm sounded, he did not turn toward the screen. When I adjusted the mask, he refused.
The next morning, when he was asked whether he still wished to proceed as he had requested, he nodded.
The physician explained the process again: the morphine to ease the pain and breathing, the oxygen weaned slowly, and what would happen step by step.
He listened without interrupting, eyes fixed on the physician. When it was finished, his voice—thin but steady—said he was ready.
The comfort care consent form was placed on the tray table. His son put a pen into his hand. The signature came out uneven but legible. Beneath it, he wrote the date.
The room was quiet while the medication was prepared.
I held his hand. His skin was pale, swollen, cool. In my palm, his fingers moved once—lightly.
His eyes opened.
There were tears there, but they did not fall. They gathered, bright against the dim light.
The morphine infusion was started. Clear medication moved slowly through the tubing, drop by drop. The pump made a soft, steady sound, almost quieter than the fan in the corner.
The oxygen remained for a while.
His breathing, which had been tight and deliberate for days, began to loosen. The muscles along his neck softened. The furrow between his brows eased.
No one spoke.
The oxygen was turned down gradually.
Seventy.
Fifty.
Thirty.
The nasal cannula was removed last. It left a faint line across his cheeks. The high-flow oxygen machine was switched off.
The morphine continued to flow.
He lost consciousness.
The space between breaths widened.
His chest rose—
rested longer—
rose again—
then did not.
I sat beside him, holding his hand. The skin was still cool, still swollen. In my palm, his fingers no longer moved.
I stepped into the hallway. The door closed behind me with a muted sound.
Downstairs, the hospital shop was nearly empty. A small rack of necklaces turned slowly near the register.
I chose a plain cross engraved with the word “love.” The metal was light in my hand.
I gave it to his son without explanation.
He closed his fingers around it and nodded once.
Later, in the chapel, the lights were low. Someone had left a paper cup of tea for me. It had gone lukewarm.
I drank it anyway.
There was bitterness at the bottom.
Caiwei is a Chinese American writer whose work has appeared in Beijing Evening News, World Journal, United Daily News, and KevinMD. A former physician, she writes narrative nonfiction that explores the intersections of medicine, memory, and everyday life. She lives in the United States.