Death Becomes You

It's a difficult thing to do as a physician -- realize and accept that there is nothing more we can do to make the patient well and hold out that sheet of paper that says D N R on it, waiting for a signature.

Yet there I was, using every imaginable term, showing every imaginable scenario, and explaining every minute detail in as layman as possible to the relatives of a patient with terminal cancer with metastases to everywhere.

It was disconcerting because the patient was relatively young for a cancer patient (<40 and some) and leaving behind a family. I talked to his brother who said the patient had a brilliant mind but it was sad that people would not see it again. His wife grew teary-eyed with every thought I injected into her mind with my appraisal. Finances were also becoming an issue.

Encephalopathy had crept in slowly during the patient's stay numbing his sensorium and taking away conversation with friends and family. Now he looks like he stares into nowhere and looks at people without a hint of recognition.

There are many cases where doctors stand in the middle of all the emotional, financial, medical, physiological issues of an impending-death situation, and I've faced some in the past as an intern, a PGI, and even way back as a student, but I realize, I still take it just as hard.

Some people are given the impression that doctors are heartless, money-driven and think only of themselves from their experiences, and yes, those people exist, but not all of us become death impersonate. Most, in fact, are considerate and compassionate but misunderstood with their approach to appraisal and getting relatives to see their points.

I appraised them, and with a heavy heart, hoped they would sign the waiver. For their sake, for the patient's, and for mine (I'm barely 3 days into residency), I hope they would.

To see the hurt and pain in a wife, son, daughter, parents or friends of a dying patient is one of the worst things to see in the profession, but we deal with it. It's easier for non-medical personnel in my opinion, but for us, I think we have to draw a piece of it, carry it with us for the rest of our healing days so that we are driven not to see that pain in our patients' eyes.

Death becomes a guy in a white coat. Well, not quite. Most of us in white coats and toting stethoscopes have hearts too.