Nathan Phillips remarked to me that trees were like lungs. I thought, it’s far more than that…
In the Surgical Oncology Unit, the cancer ward, you can’t always save people. Sometimes all you can do is keep them comfortable, be there with them, then care for their families as they go. You see the many ways that each person dies. You see the young woman with breast cancer who stays alive to see her daughter graduate from High School or get married. You see the angry person go, full of tension and knots of rage. You are surprised that someone didn’t make it through the night, when that person seemed so well the day before. Each death is unique. Each death is unpredictable. Each death tells the story of the life that has gone before. Was it full of love? Tyranny? Isolation? Fullness? Humor and joy?
The final catastrophe that ends a person’s life is never predictable in every detail, but it is reflective of everything that has gone before. So it is with each ecosystem we see in failure. Some are dying of poisons dumped on them. People are ill from polluted water that is also poisoning the plants and animals. You see it in the air and the land, in the cities, where the heat zaps suddenly kill the trees. Young trees, their leaves turn brown at the edges, and then entirely, and then the tree is completely gone, just a trunk, no sap, soon to be cut down and replaced with another tree that will fail. Or coral reefs, blanched, failing, from so many distant causes, from ocean acidification to sunblock chemicals that do not biodegrade. Who would have guessed that such distant causes could bring this about? He seemed so good last night, what happened? We can skate along for quite a while, and then the collapse comes, and comes quickly, irreversibly.
Consider the corpus of this complex system, the geology of our bones, the acid-base balance of our fluids, the failures of our circulations, the pulmonary failures, the dehydration, the fever. As our earth is mined, with vast volumes of solids, liquids and gasses removed from the structure of the earth, do you wonder why we have so many earthquakes and volcanoes? Please call the orthopedic consult. As the atmospheric CO2 level rises and is absorbed into the ocean, the resulting ocean acidosis will kill, won’t it? Please get a nephrology consult. Please hang an IV with bicarbonate in it, as we do for people in acute cardiac failure. As the Jet stream slows and the deep ocean currents stop, our circulatory system is failing. Please start CPR. As the trees fail, in dehydration and heat, how will the planet respire? No respirator will work here, as the leaves, the alveoli, can no longer function. There is no palliative maintenance when the lungs have failed. As flooding from water-heavy, warmer air happens, we erode our skin. Please call the burn unit for a consult. As dehydration brings desertification, how do we protect the water cycle, or restart it? The IV nurse could not get a line in, we’ll have to try a central line. As the temperature rises, all failures accelerate, desiccation exacerbates, forests burn, how do we stop this cascade of failures? Could we please increase the IV and get the patient on an ice blanket? No, too much fluid will overload the cardiac/respiratory systems, flooded lungs, failing heart. Diagnosis, climate catastrophe.
The interconnectedness of it all is central to the fragility. If the kidneys fail, if the ocean absorbs to the max, and the acidification cannot be flushed anywhere, we fail. If the trees can no longer respire, they cannot remove CO2 from the atmosphere, worsening the acidosis. If the fever and heat kill the trees, then the shade, the water cycle and the CO2 absorption are lost, worsening the fever, the acidosis. If the Jet stream is stopped, and ocean currents have slowed, are we not in circulatory collapse? The earthquakes, and tsunamis and volcanoes are making it hard to treat the patient, but we have to get the acid base balance restored. We have to get the circulation restored. We have to restore respiratory function. The burn patient is oozing fluids and nutrients; do we have adequate nutrition in the IV? Nutrition won’t matter if we cannot maintain respiration and circulation. Is this the complex collapse that is irreversible?
We do not know which of these will kill the patient. We know our patient is in a very unstable state. It is amazing that the doctor has not yet been called to pronounce the patient dead. You never know, that impulse to survive can keep one going for a surprisingly long time, but eventually…. As one system fails, it destabilizes another, and another. The complex system can only sustain so many assaults, before that last challenge becomes insurmountable. A patient on the Surgical Oncology Unit lay dying. Her best friend told a story about their working together that was completely hilarious. The patient, semi-comatose, sat up, opened her eyes, and laughed with us. That laugh was the final challenge, and she was gone.
I am the intensive care night nurse, trying to call Code Red on my patient. Can we decide to take action and try to preserve life?
For Shannon Scrofano’s class On Art and Activism at Cal Arts 20 September 2022 EARTH IS A PERSON
By Susan Farist Butler, RN, MSN, PhD, Visiting Scholar, Harvard Divinity School, 2020-2023
Copyright © 2018, Susan Farist Butler