“My First Death”
I went to a special grand rounds in the pediatrics department yesterday, and the topic was “My First Death.” It was a panel of five people, plus the doctor in charge of the pediatric palliative care service in the children’s hospital. Each of the five told a story of their first patient death in their current roles, and then the floor was open to questions, or for other people to share their experiences. I’m not an easy crier, but I admit I came close to tearing up at least once or twice.
The idea of my own death still terrifies and confuses me on some level, but at the same time I am very aware of the inevitability of death, and of the extended process both dying and grieving can become. It’s interesting to me how little we talk about death in the US. When I lived in Ghana, I was confronted with death more often, but these days I think if I wasn’t in medicine, it’d be fairly easy for me to only think about it on a very superficial level.
I feel a little self conscious sometimes when talking to people outside of my family and classmates, especially on my more bleak rotations. I feel like it’s inappropriate for me to share what I’ve been going through and thinking about, like finally writing up my advance directives and assigning at least one or two medical powers of attorney, or how interesting it is to see the variety of people who are the ones standing by someone during their most trying and difficult times (sometimes not even family or romantic partners, but people whose lives have become intertwined in unusual ways), or when the death or illness of a child precipitates the end of a marriage, was the divorce inevitable someday or would they have stayed together otherwise?
I worry that speaking my mind is being a Debbie Downer, that people don’t want to hear about these things. That the stories that I find almost uplifting in a bittersweet way, like the attending who told the fellow to stop CPR so that the baby could spend the last moments of its very brief life being held instead of being pounded upon, will simply be depressing.
What was my first death as a medical student, by the way? It depends on how you define it. Was it the patient in the Emergency Department that my resident wanted me to try CPR on (I don’t remember why exactly I didn’t “get a turn”) but who everyone was just waiting to pronounce dead? Or was it the patient I followed my entire four weeks on the general Internal Medicine rotation who we had nothing left to offer and were sending home with hospice? (Or the one I had for two days who we also had nothing left to offer and also sent home with hospice? He probably actually died first).
I’ve never had a patient die in front of me, but I’ve known quite a few patients, quite a few people, adults and children both, who either died soon after I met them, or who I know will die within another year or two.
I don’t have a specific point to this post. I think that mostly I’m wondering how much it’s okay for me to talk about these things, because they’re on my mind often, and dying, death, and grieving, are all a big part of living, as much as we really don’t want them to be.