March 25, 2010

Name: RN Clara Hart
Posting date: 3/22/10
Stationed in: a civilian military hospital in the U.S.
Milblog: From Our Perspective

I held the hand of a dying warrior who fought death. Flown to us from the battlefield he was gravely wounded, with no chance of survival. His family, at his side every step of the way, elected to fulfill his wishes of being an organ donor. As loved ones gathered at his bedside saying final goodbyes, the OR and organ procurement team readied the operating room and started the process of organ compatibility.

No eye was dry in the ICU as he was wheeled from the room and down the hallway toward his final
surgery. In organ donation at our hospital the family has the option of going into the OR to be with the patient until they take their last breath. His family elected not to do so. After being placed gently on the operating table he was disconnected from the ventilator and life sustaining medications were turned off. The wait had begun.

Just as the “golden hour” in trauma dictates that for maximum recovery the trauma patient should receive care within an hour of injury, there is a “golden hour” in organ donation. Only it should be called "the black hour," as it is the darkest of all hours. Once totally disconnected, the patient has an hour to die before the organs become unusable.

Our fine warrior, so valiant in his career, who fought so hard in life, continued to fight in death. Disconnected, he started to breathe on his own. Sixty minutes never felt so long as we watched his agonal breathing become stronger. When we reached the end of that blackest hour we gazed at each other, once again in tears, hardly able to bear what we knew came next.

This family who had already said goodbye once must now say goodbye again. The hope they had held, that perhaps in one’s death another might live as they received a stronger heart, healthier lungs, undamaged kidneys, was now futile. We carefully removed him from the table and placed him back in bed. The physician went to talk to the family and we rolled him back to the ICU.

For three more days he fought. For three more days his family and friends sat vigil. The nursing staff passed out coffee and gave hugs. We wiped tears and held hands. We listened to stories and laughed uncontrollably at the adventures of his all too short life. And we became tired. The dread at returning to work only to see him still battling was overwhelming. The emotional drain was all consuming and soon everyone was saying out loud what we had kept silent: “I wish he would give up." Even his parents put those thoughts into words.

At a moment when there was no one at his side I quietly walked into his room. Laying my hand along his check I leaned down and softly said to him, “We know how hard you fight, how hard you always fight. But now it’s time to stop. You gave absolutely everything for your country, your family and your friends, and I thank you with all my heart. Please let go.” I gently kissed his forehead and left the room. Three hours later this valiant warrior died.

A family member gazed at me with tears in his eyes and said, “How can you deal with things like this all the time?”

“It’s what we do," I told him. “It’s what we do.” 


Thank you for being there for the fallen and their families. The toll on the caregiver is enormous but an absolute necessity for the ones going through a traumatic time. Knowing there is one who cares and is a supportive personality is worth more than can be expressed monetarily.

Thank you for being there for ALL of them... God Bless You!

Thank you...

As an OR nurse, organ donation was one of the hardest things I did. God bless her, for she most certainly had the hardest.

As the story states "not a dry eye in the room", I had tears of my own. At one point, my vision was blurred due to the tears. This is a story you don't hear often in the news. We only hear of the fighting. Thank you for sharing.

Ms. Hart,
Thank you for your kindness and compassion to those who serve our country. Sharing your stories with us brings us all closer to the sacrifices made - by our soldiers and by you.

Giving someone permission to let go, to stop the terrible struggle to live for those who love you when living isn't anything like it was, is the bravest thing a true human being can do. Thank you, Clara Hart. It may only be what you do, but it's bravery of the highest order.

Thank you again, Clara. I do get overloaded when we escort the remains. There is this keening wail, a scream, modified by grief, and a long wailing cry.

Usually it's the mother or grandmother of the young man. It just guts you out. You can't 'not-feel' it. Yes, you do want to drop the flag and run. Run until you are away from the grief, so eloquently and keenly expressed in that long agonized wail.

I just stand there, at attention, silently adding my tears to the pool of grief that is all around me. It's all I can do.

Richard - I know that cry only too well. I have heard it more times than I can count and once you hear it, you just KNOW what it means.

I remember working at the trauma center, focused on my patient and what needed to be done until I heard that piercing wail and I knew. I had no idea what had happened nor the how or why but I surely knew the sound of overwhelming grief.

I commend you for the difficult job you do. You will be in my prayers.

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