Thoughts on death

I wonder if we ever get used to death. I had a patient in the hospital on hospice...which means they are expected to die - they are 'in the process' of dying. From the moment he came in, he was basically unconscious and in no pain. It made me sad that the family wasn't around much, and he was so young- 40's.  Yesterday morning when I was seeing my patients, "rounding" we say,  I came into his dark room.  He was there, on a face mask for oxygen (just a cup around the chin that helps aim the air to the mouth). His eyes were closed, he was breathing hard. His arms were all puffy from too much fluid, so that when you squeezed his hand, you made a dent. If you don't know if they can hear you, I guess it's better to pretend they can, so I spoke out loud. But as I heard my lone voice speaking in this empty room, asking how he was, I felt a little silly.  Can you sense the end? There was nothing different about him at that moment than the other days I visited, but something in the air was charged.  I felt compelled to acknowledge this, "Reggie it's almost over, your suffering is almost done".  I patted his arm one more time and went on with my day. 

2 hours later our whole team came in to see him. Eight of us filed in around the bed, I got ready to speak when I stopped- it was so quiet. The loud harsh breathing noise wasn't there.  His skin still warm, I looked to my attending "I think he's just passed".  We listened for heart sounds, breathing, pupil reactions, etc.  He was gone.

Will I ever comprehend the ceasing of existence? The idea that "He" was there and alive earlier that morning and now "He" does not exist? The essence that was "Reggie" had vanished. Life and death are such opposite entities, it is hard to reconcile my memories of him laughing, speaking, and complaining with the empty mass of flesh lying there. Next came the hardest part of medicine, moving on.  Stopping all thoughts of sadness to go about the next order of business. Though outwardly I had to continue my day, as if pronouncing him dead was on par with listening to the next patient's lungs; inwardly there was an alteration...a slight shift in my brain. Do we get used to death? I hope not, I haven't yet.