Carin Mikos 0:01

Welcome, and thank you for being here. My name is Carin Mikos and I am a registered nurse and end of life specialist. I am also the host of In the Gap, a collection of stories from folks who stand in and work in the gap between life and death. I figured since this is the pilot episode, I would start with a story and a little background about myself. I've been a nurse for 27 years and I've been in hospice for the last four or five years. It's been a remarkable career and I knew way back in the beginning of this career, I knew as a nursing student that there, there was this space that I had discovered that would become significant to my future as a death doula. It was on the oncology floor where I was assigned to take care of this patient. Let's just call him Tim. And he was dying during my visit to his room before and after shifts and during lunch breaks. We had these most amazing and honest conversations. And these conversations were about living, not necessarily about dying. He created this space where I was able to ask him questions about, what's it like to have this limited time. And is there anything that he had wished he could have done? He said things like, he wants to travel more, he wanted to create memories with his family. He wanted to have Sunday dinner with everyone around the table. And he expressed wanting to go to the beach and build sandcastles with his grandchildren. I helped him write these letters to his wife, to his children, to his grandchildren, and I made sure to say goodbye every time I left his room and to just thank him for, his precious time. I showed up one morning and learned that Tim had passed. In the night, and he passed quietly, peacefully, and with his family just surrounding him as he had wished and expressed so many times, and it was through those conversations with Tim that I realized that I was meant to, dance in that space between life and death. Years later, I had another memorable experience with a patient Kathy and her husband Don. I was their hospice nurse. I was there to admit her onto home hospice services. And when I walked into the room, into the house I could hear the machinery of the concentrator, the oxygen concentrator, and just the work of breath that was happening down the hall. And Don, the husband, his face was just incredibly worried and so tired. Oddly enough, too, I could smell chicken soup, in this undertone way, wafting through the room. I looked at Kathy and I knew immediately that she needed some morphine. And as a death doula, I could really just sense that. Her time was short and precious. When I asked Dawn, her husband if the morphine had been delivered he hesitated, and I sensed his apprehension. I asked him if, we could have a difficult conversation about it. Maybe even a sensitive conversation. We walked back into the kitchen, sat down at the table, and, I just... I asked Don if I could be totally honest with him. Did I have his permission to speak frankly? I watched for the first time, the tears well up into his eyes as he agreed. And I told him that his wife had very little time left. And first, we needed to get through this night. And then I asked him about, what was that hesitation that I sensed around the morphine? He shared his concerns about it being too strong or causing constipation. Then he also confided in me that their son had died three months prior of an overdose and that Kathy had barely eaten since. His pain was so palpable and now those tears just flowed easily right over his cheeks. I held his hand. I told him this wasn't going to be easy, but that we, hospice, we would be there every step of the way. I explained to him the purpose and the dosage of the morphine. How it would actually help her breathing. It would make her more comfortable. And he agreed that was the goal. That is what he wanted. And that is what Kathy would want. So I showed him how to draw it up. How to dispense it. I offered to give him, I offered to give her the first dose. And I told Don that look. I'll give the first dose and in 15 minutes, Kathy is either going to make me a hero or a fool. And we laughed a little. And it was exactly what we needed in that moment was a little, just a little laughter. So we returned to Kathy's bedside. I gave her that first dose of morphine. It's a liquid concentrate. It just goes. under the tongue. She doesn't even have to swallow it. It gets absorbed. And within, I don't know, it was like five to six minutes, Don and I just stood there watching her. And I felt myself, I was like, I was holding my breath. Within a couple of minutes, Kathy was finally able to slow down her breathing, take a bigger breath. She was actually able to talk a little. A smile. This is the part that gets me every time. A smile broke out on her face and she looked right at Don. And she was so much more relaxed. She just looked back at me and at him and she just said, thank you. Now it was my turn. The tears just started welling up in my eyes. So Don takes Kathy's hand and they just begin to talk like nothing, like everyday things. They talked about the grandchildren. What have they been up to? He talked about the chicken soup. That was on the stove and his plan to make, grilled cheese because that, in his opinion, was the best combo. It was just one more conversation in their 62 years of marriage, but it was a big one. And as a death doula, I created that space for their love and their loss to coexist through a shared conversation. Their love and life were celebrated. in those final moments in that final conversation. And that is the kind of story that you can get here at In The Gap. Thank you for your listening. Thank you for being curious. Please come back again. The next episode will air two weeks from today and this will be an interview with Karen Enders, who is the home hospice director at the Connecticut Hospice, which is the first hospice in the whole US. Thank you for joining me as we explored the lives, the jobs, and the stories from the experts who spend their time in the gap. This show and all of our shows are live streamed to your favorite podcast platform.