by Milli Desai
All patient names and identifying information has been changed to uphold privacy.
I was third in line to perform chest compressions. Emergency Room bed 6 was filled with the synchronized chaos of a cardiac code. My heart was pounding out of my chest but this was hardly the loudest thing in the room – things were moving around all over the place as everyone seemed to know what they were doing, except me.
Now, I was about to be second in line. Someone asked me if I remembered how to do chest compressions and I mumbled “yes”, trying to quickly replay the steps in my head and hoping that my arms were strong enough to sustain chest compressions…it had been a while since I worked out.
And then, nothing. The time of death was declared, and the commotion in the room turned into calmness. There was nothing more to do, and the medical team started to wrap up and walk away. All we knew was that John Doe was likely in his 60s, had a cardiac pacemaker, and was brought to the emergency department in an ambulance from the facility where he was living after being found unresponsive.
I thought I would have a personal relationship with my first patient who died. It was exactly the opposite. Though the medical team had done everything we could, it was difficult for me to walk away from that room without knowing more. So, I tried to learn more about John Doe. I tried to learn his real name, his age, his medical history, and what led to his death. I wished I could learn about his hopes and dreams, hear his stories and life lessons, and talk to his family members. I wanted to know the circumstances in which he lived. I wondered what his last conversations were, and if he felt ready for death.
There is a sacred bond in knowing these things, in having our patients open up to us and teach us about the mysteries of the human condition. This is the kind of bond I assumed I would have with my first patient who died.
My attempts to learn more about John Doe were not successful, and I realized I would not be able to have this sacred bond with all my patients. But I owed it to my future patients to try. I made a commitment to try to ask each patient I encountered a question about their life, anything that would help them feel heard and would teach me something. This experience made the moments I can share with my patients a privilege.
It was still a sacred moment to observe John Doe’s death – despite not knowing anything about him. In the Healer’s Art elective course I had taken as a first year medical student, I wrote a letter to my future first patient who would die. This exercise helped me think about what I might want to ask someone as they faced death. And later in my medical school career when I observed John Doe’s death, I found clarity in knowing that someone had thought of asking him these questions about his life, even if he was not there to hear them.
Milli Desai, MHS is a medical student at UC San Diego. You can follow her on twitter @millidesai.