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Let the Family In

This story was originally published in Nursing, a publication of Springhouse Corporation (now Lippincott Williams & Wilkins), in 1983. It was the highest-scoring Sharing article that year and was sent to all prospective authors for more than 10 years as an example of ideal style and form.

I’ve told this story many times, but I want to tell it again. After you hear it, I think you’ll understand why.

I’m out of nursing school just about a year; fresh, energetic, ready to conquer the world’s ills with my new skills and caring. As charge nurse in an urban emergency department (ED), I’m relieved things are going well tonight—not too busy, not too slow. Glancing out the window, I notice a light rain has begun to fall. Then a call comes from our ambulance service: They’re bringing in a head trauma case from a car accident.

With the precision of any well-rehearsed team, we prepare for the impending emergency. When the gurney rolls in, we move into action. The transfer between stretchers is smooth, sure. One intravenous line is started, then another. Oxygen is administered. It’s a minute or two before I really notice the patient as a person.

She’s a young woman, 19, perhaps—restless among the stir about her. She’s alert, but with that curious confusion that really isn’t confusion…yet. She speaks clearly, complaining of pain in her head, stomach, leg. The dark lashes blink repeatedly over her large, blue-green eyes. "Where’s Daddy?" she asks. "Why are you doing all this? Can I see my father, please?"

I’m a good nurse. I explain. She’s been in a car accident; we’ve called her father; he’ll be here soon. We continue treatment. The flurry of activity around her bed (her name is Suzanne, by the way) is calm, organized, purposeful. We’ve accomplished a lot but we still have a lot more to do when the unit secretary tells me Suzanne’s father is in the waiting room.

He is, predictably, middle-aged. But I’m not quite prepared for the anguish in his eyes—the same unusual shade as Suzanne’s. I look instead at the top of his head, his hair flattened down by the rain. His voice hoarse with worry, he says, "Suzanne…how’s my daughter?"

I’m a good nurse. I explain. Suzanne has been injured in a car accident. Her leg is broken; she has many cuts; she’s lost some blood. The main concern, though, is her head. Her skull is broken in at least two places. She’s in critical condition. I finish, "We’re doing everything we possibly can. The doctors are in there right now, and as soon as one’s free, I’ll send him out to tell you more."

"Is she awake?" he asks. "Can I speak to her—just see her, please?"

I’m a good nurse. I hedge. All the tubes, bottles, machines, and blood may worry him more. He may stay too long, see things he shouldn’t, ask questions I can’t answer.

"I’m sorry, not just yet. So much is going on right now. Let us get her a bit more stable. Then, I promise, you can see her."

At the time, I don’t realize I’m playing God—and I’m really not equipped for the role.

He blindly accepts my refusal, nodding a polite, automatic thank-you. I watch him walk slowly down the hall, his shoulders shaking.

At the bedside once again, I ask Suzanne how she feels. She’s lying quite still. When she mumbles something I can’t make out, I shake her to get a response.

Oh, God, I think, she’s going out on us. We alert the neurosurgeon about the change. He decides to take her upstairs for an arteriogram before surgery. While we prepare for the transfer, Suzanne deteriorates further. I go with Suzanne to radiology to assist the neurosurgeon. Again, I try to get a response. Open your eyes, Suzanne, talk to me. Talk to me, please. But she doesn’t; she has slipped into a coma. She will die, I know.

Because more staff have come in, I can return to the ED. Relieved of one burden, yet afraid of another, I walk out into the hall.

There I meet Suzanne’s father, his face ashen and blank. I hear myself telling him Suzanne’s condition hasn’t improved. She’s having tests done and will go to surgery almost immediately. Things haven’t improved. I wonder, Do the words seem as meaningless to him?

I shake my head. I can say no more. He nods understanding—the unspoken penetrates his shock. I turn away, nearly running; I never thought I’d see the ED as a place to hide.

I begin to function now more by instinct than thought. I keep remembering the promise I made to Suzanne’s father. Why didn’t I let him see her? Did I deny him his last chance to see her alive? God, please let her live, I pray.

I call the operating room; "No change" is the answer. An hour drags by. The phone rings; this time another answer—Suzanne is dead.

Steady, I tell myself, you’ve got to finish your shift. But inside, deep, the arid feeling of failure and guilt deadens every other emotion. For nights afterward, I relive this evening in my dreams.

Later, I find a lesson, clear and unequivocal: Let the family in.

No matter what, no matter when, no matter how, let the family in. Let the patient see the love only a family can show. Let them see, let them speak, let them touch. Prepare the minds and soften the sights—but let them in.

I owe a debt to Suzanne and her father I’ll never be able to fully repay. I try, though. And maybe you can help me: Let the family in…please.