Dying

I'm reading a book called Final Exam; it's a memoir by a surgeon detailing her journey towards her understanding of death as she went through medical school and became a doctor. It's bringing back several memories, some of which I already wrote about in my Haiti journal, but I felt like re-visiting them here.

I have already been the one to pronounce a patient dead. It was in the back of a pickup truck in Haiti; they rolled in with a man unconscious in back and we're not sure when his heart had stopped beating. A nurse took charge and jumped in with me, and we starting doing CPR, while the American doctor came and tried to feel for pulses. Nothing, nothing. The nurse and I switched off, and every now and then we would pause so one of us could listen for a heartbeat. The most unnerving sound I have ever heard in my life was when I placed my stethoscope on a man's chest and heard - nothing. So we go back to CPR, and after about 15 minutes the doctor catches my eye and says, "Do you want to call it?" I kind of looked at him and then back at this man lying in the dirty bed of a pickup truck, eyes closed, mouth open, and I said, "yes." The nurse stated the time and someone wrote it down, and that was that - the first time I pronounced another human being dead. It didn't really feel weird at the time; I mean, dead is dead, and I was just saying what the facts were. But now reading her book I realize that was a big moment, a really big step for me, and a really saddening one too.

I'm not going to pretend that seeing several people die in Haiti did not affect me. Watching the man who had been shot through the groin as his breathing stopped and his heart monitor all of a sudden went flat; seeing his wife's eyes fly open and hearing her soul burst into a wailing mourning piercing shriek - I'm not going to pretend that didn't send chills down my spine. I still can see the eyes of the 16-year-old girl gasping for breath as she looked up into my eyes as she died of tuberculosis; I'm not going to pretend it doesn't disturb me. I don't understand death yet, and I'm still afraid of it.

There was a woman working with us in Haiti, a respiratory therapist, who noticed me the first time I saw someone die. She must have seen me go pale, or my eyes open up wide, or heard my breathing stop, or whatever I did. I don't remember exactly what she said. I do remember that it was incredibly tender. I don't remember what she said, but I know I was comforted, and I knew it was going to be okay. I'm glad she was there to help me in that moment of complete helplessness and confusion, and I hope I will be able to continue to progress in my understanding of this scary, peaceful, incomprehensible event of death that will be such a huge part of my profession.