Do Not Disturb

Written in red magic marker, the makeshift sign on the door says “Do Not Disturb—Please see nurse before entering.” On the other side of the door is my patient, Esther. Yesterday, Esther underwent surgery for a ruptured appendix. Prior to surgery, I spent an hour trying to convince her to have it done. She said no one else but I could talk her into it. She finally agreed, on one condition: I had to promise to keep her comfortable after surgery.

It is early morning and I can see heavy snow falling on the streets below. The hospital halls are empty. Esther's nurse is not in sight, but I hear voices and faint laughter down the hall.

I pause at the door, debating what to do. I think about all the patients I have to see before heading to my office. I stare at the red letters on the door for another moment. I cannot remember ever hesitating to enter a patient's room, sign or no sign. I'm the doctor, right? I have to check my patient, the one who just had serious surgery. If I do not go in the room, what do I write in the progress notes? How do I bill for a visit that never happened?

At 93, Esther has endured bypass operations, heart failure, breast cancer, hypertension, and depression. She raised five children and several grandchildren by herself. In our recent conversation, she told me she'd had enough—enough of illness, doctors, hospitals, and family problems.

“And don't you tell me I'm depressed. After 93 years, I ought to know something about how I feel!”

I walk down the hallway to find Esther's nurse. As we walk back together, she explains to me that Esther is refusing her blood pressure medicines and heart pills. She only wants medicines for pain and nausea. She does not want to be disturbed.

From a small window in the door, the nurse and I gesture at Esther's daughter, Anne, who waves me in. I tiptoe past Esther's bed and sit on the hard couch next to Anne. The room is dark. I can see Esther's face beneath the gray blankets. I ask Anne how Esther is doing, and she tells me her mom had a restless night without much sleep.

“Do you have to wake her? I wish you wouldn't.”

I get up and walk to the end of Esther's bed and watch her breathe—in and out, in and out. I close my eyes and listen to her breathe—rhythmic, smooth, and quiet. I open my eyes and look at her face. No grimacing or wrinkling of her brow. I notice a pink bow in her hair. I think about the years together, helping Esther through one illness after another. I think about the stories she would tell—her early romances, and her life raising boys on a farm in Virginia. After a minute, I wave goodbye to Anne. As I move closer to Esther, I raise my arm toward her, and then slowly pull it back. Now is not the time to lay a hand on her shoulder, touch her brow, or whisper a few words of love.