On the Monday after Thanksgiving, a three-hour car ride home from Knoxville turned into a complete breakdown for me. When I discussed this with my therapist after the fact, she mentioned that music could be a partial trigger. So, she recommended I find some podcasts to listen to during car rides for the next several weeks, and see if that helps.

The next time I got in the car without the kids, I did exactly what my therapist recommended. I started with a grief-related episode of I Weigh with Jameela Jamil, then moved to Last Day, a podcast Emily’s mom had mentioned while we were on vacation in August.

Last Day is a podcast two sisters started after they each lost a sibling to accidental overdose related to opioid misuse. I realize the topic of the podcast (issues that are killing people in America) has nothing to do with Emily’s death. Yet as I listened to one of the episodes about how normal one brother’s last day was, I couldn’t help but think about how much that same sentiment applied to Emily’s final 24 (or really 36) hours.

A Final Mundane Monday

I’ve mentioned this in other posts, but I will say it again: I’ve replayed the footage on those final two days of Emily’s life over and over again. I keep thinking that I’ll pick up on some clue, recall a moment that I missed, or finally piece together what I could have done differently to save her.

None of that has happened yet. Instead, all I’ve pieced together is that it never really seemed like the end until it was.

Monday, October 17 mostly started like any other Monday. Emily’s schedule meant she was almost always off work on Mondays, and the kids go to their dad’s after school, so it was our day to enjoy together.

I took the kids to school. I texted Emily as I left the school to see if she needed anything. I let Emily sleep in while I started my work day. When Emily came downstairs, she mentioned her abdominal pain, but insisted it wasn’t too bad. She also mentioned that she just had to make it through Monday, as she had an ultrasound appointment scheduled for the next morning and was hopeful they’d take one look at her gallbladder and schedule the surgery.

So, Emily went through her usual motions for a Monday. She had a monthly appointment with her dietician over Zoom, and she had an in-person therapy appointment that afternoon. She was drinking a little bit of water, but was having a hard time eating. Both her dietician and therapist asked her about going to the hospital, which she declined because she said the pain wasn’t that bad.

Once she returned home from her therapy session, I could tell she wasn’t feeling well. We cuddled up on the couch and started watching 9-1-1. As the clock approached dinner time, I told Emily I’d make literally anything she was willing to eat. She asked for the tater tots from the restaurant in our apartment complex, but I think she only took two bites of one before she felt worse. I looked at her and said, “Give me just a minute to pack a bag, and then we’re going to the ER.” She didn’t fight it — she just nodded.

The Waiting Game

If you’ve needed any type of emergency medical care since March 2020, you know what a shit show it is. Most hospitals are understaffed, over capacity, and fighting an uphill battle. Needless to say, we knew we were in for a long wait when we walked into the waiting room at our local ER that Monday night.

We arrived right around 7:00 pm. Because of Emily’s history, they called her back for an EKG right away. That looked fine, so they sent us back out to the waiting room. They called her back for labs about two hours later, and then sent her back out to the waiting room again.

As the hours ticked by, I could tell Emily felt frustrated. She kept saying, “Clearly I’m fine since they don’t seem to be in any rush to call me back,” and, “I’m probably just being a big baby and we shouldn’t even be here.” I tried my best to remain calm and validate her feelings while also reminding her that the long wait didn’t mean she was blowing things out of proportion.

Finally, they called her back sometime after 3:00 am. Since every other room was full, they put us in what they called the “fast pass” room, which was normally for quick treatments. However, they assured us that they weren’t going to send her home immediately, and they would do what they could to figure everything out. They performed an ultrasound, gave her some IV fluids and an antibiotic, and had her take some sort of cocktail for her nausea and abdominal pain. By 6:00 am, they had determined her gallbladder was the issue, but some of her labs also looked concerning enough that they wanted to transport her to Vanderbilt (where she had her transplant).

So, after an entire night in the local ER, we boarded an ambulance to transfer. Perhaps I should have taken her directly to Vanderbilt instead of going to the ER 5 minutes from our home? I’m not sure.

It All Seemed Fine… Until It Wasn’t

Although there was a bit of initial confusion when we arrived at Vanderbilt, everything seemed in order once they got Emily into a room. The team confirmed that she needed her gallbladder removed, and a general surgeon came to talk to us about the procedure. He said they’d likely schedule the surgery for the next day (Wednesday), assuming cardiology signed off.

Emily had an ultrasound and a cardiac echo. They ran some labs. All in all, though, she was mostly free to get out of bed, use the bathroom on her own, and hang out.

Later that afternoon, someone from the transplant team came by. They made the same comment as St. Thomas about her troponin levels, but didn’t seem overly concerned. As a precaution, they scheduled a right cath for Wednesday morning, and said they’d start Emily on IV steroids that evening to counteract any potential rejection.

I think I was the only person who seemed even mildly worried. Emily seemed more concerned about my feelings than anything the doctors told her. The doctors seemed calm and collected, and they continuously reassured us that Emily would be fine.

They served her a ridiculously bland dinner. I grabbed Chinese from the cafeteria, and of course Emily stole several pieces of my orange chicken. She wasn’t in pain, she was carrying on conversation as usual, and was texting folks with updates.

At some point, I asked her if she wanted to stream something on my laptop, and she said yes. We got into a minor disagreement because I mentioned climbing in the bed with her and she insisted there was not enough room for both of us in the hospital bed. In true us fashion, we spent the next 5 minutes apologizing to each other, then I slid a chair next to her bed and set up the laptop so we could watch 9-1-1.

Part of the way through the episode, Emily started to fall asleep. I wasn’t surprised since we’d essentially been awake for over 24 hours at that point. So I turned off the show (insert more checking in that no one was mad), and she slept in the bed while I positioned the reclining chair as close to her as I could.

At some point, I think it was 9:00 or so, Emily got up to use the bathroom. I asked her if she needed help, she said no. But when she stood up to get off the toilet, her knee decided to sublux (very common issue for her), and she fell. I pushed the call button for the nurse, then asked her what I could do to help. The nurse came and got her back into bed, asked if she wanted ice for her knee, and told her to not get out of bed unless someone was helping her. Then we went back to sleep.

The Final Hours

You know that feeling when you’re in the middle of a detailed dream and your alarm clock goes off and wakes you up in a panic? Well, that’s exactly what happened to me. I woke to machines beeping and immediately panicked and looked at Emily. She looked awake, but wasn’t alert or responsive to me. A whole team of people rushed in, and asked me what was happening. I just looked at them, horrified, and said, “We were asleep. I don’t know. Everything just started beeping and she isn’t responding when I talk to her.”

Within a minute or so, she was fine again. When they asked her if she knew what happened, she said, “I woke up because I needed to go to the bathroom and my partner was asleep, and now all of you are in here.” To her, that entire period of time with the beeping machines and me trying to talk to her didn’t happen.

More labs were ordered, and the doctors asked us both questions about her medical history and health. They asked her a lot of questions to confirm she was cognitively fine, and all the nurses looked at me and said, “Aw! How romantic!” when Emily told them the proposal story.

Finally, people started leaving the room. One of the doctors told us she’d look over all the labs and let us know what they found out. Again, no one seemed overly alarmed yet, mostly just perplexed.

Emily jokingly said, “Well, I’m awake now… Let’s talk about the wedding!” We briefly discussed our plans for what we wanted the wedding party to wear (we both agreed we wanted people to pick outfits that made them feel comfortable and confident, as long as they matched the colors of purple for her side and green for mine). We also joked that we’d offer our brothers the option to wear dresses but knew all too well that none of them would.

I don’t know for sure, but I think about an hour had passed since the initial episode when, mid conversation, the same thing happened again. I couldn’t even think enough to find the damn call button, so I just shouted, “Help!”

I said her name a few times and tried touching her before the nurse ran in. He looked at her, and then immediately asked me if I would help him flip her on her side since it looked like a seizure. As we did, the same group of people from the first episode rushed in again. I stood out of the way, crying and panicking, as everyone rushed around to care for her.

It took a bit longer this time, but Emily started responding again after a couple minutes. More labs, a chest x-ray, and an ultrasound, all done in the room. They kept asking me if she’s had seizures before, had any issues like diabetes, and more. I kept telling them no, all of this was new. Somewhere during this time I texted Emily’s mom, and she called me.

At this point, Emily was responsive and still firing off sassy comments, but she was visibly unwell. She told me she didn’t feel well, and I stroked her hair. I stayed by her side while the doctors talked. She started feeling nauseated, so I grabbed one of the “puke tubs” (my term) and held it for her. I know she apologized at one point, and I just kept telling her it was okay, I wasn’t upset. I also told her I was not going to leave her side.

No one knew what was going on, so they decided to move her to the ICU so they could keep a closer eye on her. One of the doctors looked at me and said, “We’re going to figure this out. We’ve got her.” But it didn’t matter, I still fought tears the entire time I walked beside her bed as we made our way to the cardiac ICU.

We made it into the ICU room. I sat our bags down in a chair. Then I stood beside her bed as they started getting her all settled and hooked up to monitors. She looked at me and said, “Babe, I’m feeling weird. I think it’s about to happen again.” I said, “It’s going to be okay, I’ll tell them. Just sit tight.” And that’s it. That’s the last thing I said to her.

As I turned to get someone’s attention (there were 3 people in the room), the same thing happened again, only this time she completely coded. They started CPR and were all talking to each other before a nurse realized I was standing there crying. He made me leave the room and assured me someone would come update me soon.

I don’t know how much time passed as I paced the waiting room. It felt like forever. I prayed, I cried, I emailed all of our pastors to ask for prayers. I ran to the bathroom and threw up. I cried some more. I forced myself to drink water and tried every mindfulness exercise I could remember from our DBT group. I kept grabbing my phone to text or call someone, but then realized it wasn’t even 5:00am yet so everyone would be asleep.

When a doctor came out to update me, I was sitting in a chair staring at the ceiling. She told me they’d put her on ECMO, and I completely lost it. I swear Chasing Cars should have been playing in the background, because it felt exactly like a scene from Grey’s Anatomy.

And then, not even 30 minutes later, the same doctor came out to tell me ECMO wasn’t working and she was dead.

Nobody Knows

I know that most people don’t wake up in the morning and think, “Today is my last day of life.” In fact, I think most of us would say that our lives unfold much like the lyrics of Cosy in the Rocket (the Grey’s Anatomy theme song): Nobody knows where they might end up.

Emily and I certainly didn’t know how those final two days would play out. But then again, Emily did make a comment when a friend of ours visited Tuesday morning that it “felt a lot like 2017,” so maybe she knew something we didn’t? It’s hard to say.

All I know is it never really felt like the end until the end was already there, and by that moment, all I could think about was that I was too late.

There’s a lot I’m grateful for when it comes to Emily. But I think that part of me will always carry regrets. And because of that, I will never be the same.