Monday, April 04, 2005

After they die

The night before last I relieved a doc at 10PM who had just concluded a code and the elderly patient was deceased. We all hate to break the news to the family, but recognize that is part of what we do. However, the family wasn't around. I had a first: my colleague signed out a dead patient to me.

When the family arrived, I was very busy. There was no way I wanted to get involved. I was aggitated and aggravated as I went to the Family Conference Room; a place, I can assure you, you never want to be taken.

The patient's wife and son were in the room. Now, every physician has a particular way to break this kind of news to the family. I tend to begin by asking what happened at home and then describing the treatment leading up to the arrival in the EC and the subsequent treatment. Then I say something like, "Everyone did everything possible and it just wasn't enough. Mr. Patient was just too sick and [pause] didn't make it."

However, in this instance, the patient's wife just kept interrupting my carefully prepared delivery. Forget that I didn't have the first clue what had happened and was just confident in my colleague's abilities, but I had something to say and she wouldn't let me! How dare her!

I fought my rising irritation at this imposition on my busy night, just getting started. I gently (maybe not so gently) interrupted and asked, "Have you been told that Mr. Patient has passed?" She replied, "Yes," and continued to tell me about him. I mean, recent and remote stuff. Not just the events of the night.

My mind was racing with the huge number of charts (note I said charts, not patients) waiting for me. Only just into my night shift and I was already tired and irritated. Why wouldn't she just shut up!!! How did I get stuck in here, anyway? What purpose could I serve here? I had real work to do!

Then I realized that this was a woman who had just lost her husband, her companion for most of her life, a big part of her. She wasn't thinking about the number of things she had to to, or the impact of this on her life right then. She was just remembering the life of a good man, a man she loved.

Jesus told us to rejoice at death. We all know about the huge parties some cultures have, like the wakes of the Irish and the parades in New Orleans.

This is what I could do. I could listen. And so I did. I just sat quietly and listened. She wasn't talking to me as much as she was talking to herself, but I listened. Man, it felt good. I relaxed and just waited.

Soon, after only a few minutes, she looked up and said, "I guess I shouldn't keep you. I'm sure you have much more important things to do than listen to an old woman ramble on about her dead husband."

But I didn't.