She lay in bed, her breathing erratic; she would breathe in deep and fast, then exhale slowly, as if she’d just hit her first cigarette of the day. In place of a cigarette was a tube, about a quarter of an inch wide. It was stained brown, and every few minutes a bucket attached to the wall would make a hissing sound, and brown sludge would course from the tube into the bucket. Presumably, the tube went down to her stomach. The brown sludge, being contained in tube and bucket, didn’t convey a smell or any other hints as to what it might be.
Another tube was in her nose, making a faint, continuous hissing noise. It also had a bit of a brown stain, just on the tips that sat inside her nose. It ran from her nose to another wall outlet, just next to the sludge bucket.
The third tube ran out from under her blanket, across her exposed thigh, and over the side of the bed. It ran into a large, thick plastic bag filled with something that looked like urine, but with white flecks forming a cloudy layer at the bottom of the bag. That tube also had spots of brown sludge, but not exclusively, as the oral tube did.
She seemed to produce a lot of brown sludge. A bedside commode had a bit in it, and that one did have an odor, a faintly sweet but strongly fecal smell. More powerful was another bit of sludge on a shelf by the window. In between flowers in various stages of wilt; between cards, some with the neat hand of an older person, some in the large scrawl of a grandchild; next to pictures of someone who must be her, but without tubes and beautiful; on that shelf was a small styrofoam bowl filled something that looked like cooled beef consomme. It was brown, of course.
From that small bowl, a powerful scent flowed around the dying flowers, past the cards and toward the dying woman. The consomme wasn’t beef, but vanilla.
People think of vanilla as subtle; it’s synonymous with “bland”. But not this vanilla. The hospital-grade vanilla flows thickly through the room, around the sludge bucket, the commode, the still-living body. It attaches itself to other smells, sometimes accenting them, hopefully but rarely overwhelming them. It shares every room filled with brown sludge and grief.
That pleasant scent, the one that defines bland, attaches itself to something else, becoming something else. It becomes part of the smells of dying, of suffering. It becomes cloying, suffocating, insufferable. Outside the woman’s room, it may be subtle, but it hints of what is behind the door—tubes, brown sludge, sunken cheeks, uneven breaths.
White Coat Underground: Homefront Edition 
I found that death did not smell, but sounded. The antiseptic hospital (and, very probably, hospital-grade vanilla) kept the intensive care unit nearly odorless (in my perception, at least)… but there were so many beeps, of so many sorts. Once they got slow, the nurses took pity and turned the beeps off, and then there were only numbers on machines.
Dr. Pal, I cannot thank you enough for your writing. It moves me, so often, and so often in surprising ways. I don’t know whether I perceived the vanilla, but your writing took me back to those terrible days. Thank you for that, but more, thank you for being one of the team that fights against vanilla, against slow beeps, against death. Against the inevitable. You (and your type) win battles, but never the war; Death always wins the war. It takes a special type to fight a war that cannot be won. And to make a real difference–in hours, days, and sometimes years. So, yeah, thank you, Dr Pal. It means the world.
Vanilla. once upon a time one of my favorite ice cream flavors. I think I’ll switch to black cherry. I’ve had to sit with dying relatives before. It doesn’t get any easier, does it ?
Death comes with a sound track, too. I’ll try to take rounds around the corner, when there is crying accompanying the ventilator or monitor beeps, to offer a semblance of privacy for the family’s grief. Some weeks we almost run out of the nicer tissue (vs. the cheap sandpaper-like tissues kept in the breakroom).