I met Audrey Flores only once, but she played an extraordinary role in supporting the caregiving and, ultimately, dying process of my dear friend, G, on the Seattle Cancer Care Alliance Floor of the University of Washington Medical Center in the summer and fall of 2019. Audrey was G's night nurse over a period of many weeks, but our paths hadn't crossed because my visits were during the daytime. I spoke with her just a few days before G died when Audrey was doing a day shift. This led to an experience I'll never forget and have shared with numerous friends of mine and of G's, both in and outside the medical field.
Another friend of G's and I arrived for one of our regular daytime visits and because G was in a deep sleep, we asked to speak with her nurse for the day. Audrey (a name and face we didn't recognize) chose to interrupt her break to respond to our request, suggesting the three of us stand outside G's door watching in on her as we spoke. We asked for a report, not only on G's physical issues of the day but also an assessment of her emotional/spiritual state of mind. Over our visits during recent days, it was clear to us that G's condition was further deteriorating, and she was struggling to feel hopeful after an extended struggle with stem cell replacement to treat her leukemia.
Audrey took a subtle but deep breath, which we understood as an expression of stepping into the risk of having a full-hearted, honest conversation with us. During that exchange, we learned that Audrey had gotten to know G well as her night nurse, often responding to fears G expressed, ones the daylight hours obscured. Audrey described examples of words and caregiving comfort offered to G and acknowledged she sometimes stayed in G's room to do her own recordkeeping, a reassuring gesture to express "you are not alone."
She told us she was reading Atul Gawande's Being Mortal, a doctor, and a book we were quite familiar with and had recommended to G's out of state family members. Together, we reviewed the critical questions Gawande suggests should be asked in life-threatening situations, ones the three of us, each in our own way, had been trying to discuss with G, even though her ability to communicate was diminishing. As we saw G open her eyes and recognize us, we stepped into her room, and Audrey went off to find the doctor so that we could continue this discussion with G and her medical team included.
Audrey was an exemplary model to witness, seeing how we can closely watch and listen to a patient, be attentive not only to all those hanging bags of fluids but the bag of emotions that could easily be overlooked. We saw her personalize the care she offered and her astute recognition of the kind of conversation we were ready to engage in. The emotional risk Audrey extended to us enabled our ability to step into our own vulnerability in this unknown encounter with the dying process.
We are all going to die at some point, and exemplary medical professionals stay tuned to when that time is at hand and how to ease both the patient and her loved ones into that experience. Audrey Flores is one such professional to be recognized.