Contributor: Mary Ann Lavin, ScD, RN, ANP-BC (Retired), FNI, FAAN

I selected the poem below by Juliette Ligon from the Internet (retrieved December 11, 2022 from the Poetry Soup website) .It was written in 2019. I selected it because it so much mirrored by own experiences of unconsciousness. The first time was due to an arrhythmia when I was swimming underwater 75 yards to qualify for lifesaving at age 14. The lifeguard jumped in, pulled me from the pool, and plopped me on the side. I suspect the plop restored normal sinus rhythm. I asked him why he did that. He replied, “Mary Ann, you were lying on the bottom of the pool.” Only, I thought was still swimming and I remember being at tremendous peace. In brief, I remember thinking just as the poet describes in this poem.

The next time I was unconscious, I fell hitting my head against a curb running back to a friend’s home during a storm. We were on a scavenger hunt. I was the last one running, so no one saw me fall. I suffered a linear fracture of the skull and a moderate brain concussion. Unconscious, I was still thinking, albeit not rationally. I thought the parked car in front of which I fell was rolling slowly and about to run over me. I retained this thought for I don’t know how long. Finally, as I was awakening, my friends were coming back to find me, having finally missed my presence at the party.

Although I did not write this poem, I want nurses and students to know that the experience described is not unlike my own — although my unconscious episodes were so much shorter. Poetry and other art forms are important in expanding our own nursing knowledge base.

The lessons to be learned? Do keep on talking to comatose patients, play gentle music, reassure them, tell them you understand that even though they can’t respond, you know they are thinking. Even though they cannot manipulate their own environment nor interact with it, you can manipulate it and interact with them. This is not to say that every comatose patient has the same experience; but, isn’t it best to assume they can hear you? Isn’t it best to assume they are thinking? Thank you for listening to my long introduction.

“Comatose”
by Juliette Ligon

In an irrevocable warp speed instant, my head collided into the likeness of drying tar,
absorbing each horrid layer of concrete.
That pitch-black, tacky substance covered my body,
so that I was trapped, sightless, into immobility.

With pounding pain, like a full force baseball bat swing
to the skull, like a head cold amplified myriad times,
my brain screamed for release
inside walls of perpetual pressure,
with nerve spasms massively extending
beyond the central blow.

The stench of blood-covered latex gloves
and hand sanitizer attempting to halt disease,
had me guessing that I was in a medical facility.
I could taste metal, as if I was becoming part machine,
conforming to constant monitor beeps.

Morphine drips slipped me into hallucinations,
or maybe just distressing dreams.

My opaque mind tingled for air, breath gasping
like an incessant snore, mouth slightly ajar.
I imagined drools somewhere, but felt no dampness.

Numbness soon overcame most pain,
setting me into a panic of possible lost limbs,
lost neck, lost head.

Dread of the unknown
cast me into a guarded sensation of
always falling, anticipating the jarring end.

Unable to scratch intermittent itches
or ask for assistance, I twitched inwardly,
trapped in a corridor of horrors,
with siren flashes passing through the darkness,
running for a door or window to open,
or if locked, to kick vigorously
through this mind prison.

There are no doors. There are no windows.

Only echoed pounding of
familiar voices floating
surrounded me.

I could smell my wife’s Tea Rose perfume
upon approach, accompanied by
my three mostly grown daughters
with their authentic scent of home.

Some named friends and acquaintances
came at arbitrary times.
Some offered slurred words in somber tones.
Some were simply saturated in silence.
All were drenched with unspeakable grief.

Each loved one’s screaming drop of saline
made me cry inside, but I doubt it seeped outwardly.
I longed to reach out to wipe away their liquid sorrow,
but my muscles were limp, each limb
like a redwood tree branch in stagnant air.

Copyright © Juliet Ligon | Year Posted 2019

The next poem. “Life’s Questions,” is my own. Having worked in CCU once upon a time a long time ago, I know of several stories of indescribable peace described by patients after being defibrillated. Some even awakened angry, saying “Why did you do that? I was so much at peace.” They were even more mad than I at the poolside. I know of a physician being awakened by defibrillation saying something to the effect, “I am unsure of what I experienced, but I know I am no longer an agnostic.” Of course, the question of change in brain chemistry or Divine Outreach cannot be answered by direct evidence. But, as nurses, it is good for us to know we are the ones so near to the question even being posed.

“Life’s Questions”
by Mary Ann Lavin

Swimming
The water so warm
I am at peace
Only ten more yards
Thirty more feet
So much peace
Utter quiet, utter peace
Swimming, just a little more.
Suddenly, peace broken by a hand
Beneath my swim suit strap
The waters break
“Plop” I am dropped poolside
And to the lifeguard I shout
“Why did you do that?’
Not knowing quite what “that” was
The Breaking of My Peace?
Or simply an unwanted interruption of
a lifesaving test’s underwater, seventy-five-yard
swim?
The lifeguard’s response?
“Mary Ann, you were lying on the bottom of the pool.”
Sixty-seven years later, a physician asks
“When did your ventricular arrhythmias begin?”
“Let me tell you,” I say, “of a 14-year old’s
Underwater swim, of consciousness unapparent to others
Even while life was ebbing unapparent to me
And of unimaginable, silence-encompassing peace.”
The brain’s chemistry changing?
Or, Divine Outreach?

Some posit that poetry is one way of knowing nursing. If so, then this way of knowing is a portrayal of nursing’s inner meaning, experience, and responsiveness.  Poetry captures even more, both the intensity and the art of nursing. It is an artistic and literary genre to which every nurse may contribute.  Do please feel free to do so. 

About Mary Ann Lavin

My name is Mary Ann Lavin. I have practiced in Bolivia, taught nursing in Ecuador, served as a Clinical Nurse Specialist in a CCU, Directed a Master’s Degree CVN Program, started a health outreach program in rural Missouri, served as founding clinical services director of a clinic for Hispanic immigrants in St. Louis, operated a clinic in an apartment building for the elderly and disabled. Except for Bolivia and Ecuador, the remaining practices were part and parcel of teaching MS and DNP students at Saint Louis University, from which I too graduated. My nursing education was complement by two degrees (M.S ’74. and D.Sc. ’78) from Harvard School of Public Health. Almost forgot: Kris Gebbie and I called the 1973 First National Conference on the Classification of Nursing Diagnosis, which birthed NANDA in 1973. Peggy Chinn was an active member of that conference serving on a nursing panel.