A Doctor Learns to Cope with Inevitability

Someone died at work today.

It’s not everyday that someone can say this, even if you work in a hospital.  I usually see patients on the medical floor where, pretty much, my job is to keep patients alive or, at the very least, comfortable and pain-free as they meet their creator. Benign and not too stressful.

It’s totally unlike what we see on prime time television shows such as ER and Grey’s Anatomy which show glamorized death scenes, complete with literal rhythmic heart-pumping action and frantic placing of lines, and shouting of drug orders. But if it comes with hot, McDreamy doctors, hey, I’m not complaining.

Which is why I still get frazzled when a code blue is called — meaning someone needs to be resuscitated.

In my opinion, patients do not transition from being stable to being half-dead in minutes. Unless, of course, they had a massive heart attack, or had massive blood clots in their lungs, or had a fatal abnormal heart rhythm. Usually you are able to sniff out those people who, for one reason or another, don’t look too good. It’s unexplainable but, really, there is a gut feeling that something is amiss and you had better watch out.

Someone once told me that, in their nursing home, the resident cat is usually able to tell who is going to die next. The cat would linger in a patient’s room and, true enough, that patient would soon get a heavenly discharge. Um, first of all, why is there a cat in the nursing home?!?! Actually, many nursing homes provide companions animals which, studies show, bring great mental and emotional benefits to its elderly residents.

When I entered the patient’s room I was told that she was found unresponsive with no pulse. She had just been admitted earlier that day and, supposedly, had been arguing with the doctor as to why she needed to come in.  She was just casually in the clinic to get clearance for some eye surgery and happened to tell her doctor about some dizziness and near-fainting. Subsequently, she was sent to the ER and was told she had to be observed overnight.  After 30 minutes of chest compressions, she was pronounced dead.

This lady, who was walking, talking, arguing with her doctor, who wanted some eye surgery… was now dead.

I remember the first death I encountered as a medical student. Before that, I used to think about how it would feel to actually watch a person slowly slip away. Would I cry? Would I feel some spiritual transformation? Would I be able to handle it? Back then, I personally had very little experience with dying. I was only six years old when the only person semi-close to me died. It was my grandmother. I was sick and couldn’t attend her funeral.

I remember I was on the oncology floor, and the patient had been a breast cancer victim.  Her son, in his 20s, was watching and crying unabashedly as we tried to revive her, to no avail.  In the end, I was crying as I repeatedly told him, “I’m sorry, I’m so sorry”.  I have no idea how my little words could provide comfort to him. This lady was a daughter, a wife, a mother, a friend and, now, just like that, she’s gone. An entire lifetime flashed in a matter of less than 30 minutes.

There is a song by Mat Kearney entitled Closer to Love, and a particular line always gets me thinking… I guess we’re all one phone call from our knees. I think that if that phone call were about my parents or any family member getting sick or dying, that would be it.

For some reason, I just never thought about death too much after that. I never cried again at any death. It was almost mechanical, expecting some people to die. But that night, I was overcome with deep sadness about my realization of this fact. I don’t want to be a robot. I don’t want it to be mechanical. I want that person’s lifetime to matter to me, even when she was just a stranger.

I cried as I was walking back to my room, the kind of crying you do when something that’s been building up inside you finally gets released.  I surprised myself as I actually said a little prayer for her soul.

I then turned over my pager to the night person and headed back home,  hoping that I never get that phone call. ♥

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