Hospital is a place of strange rituals. The doctor needs to sign this and confirm that. Even if they don’t know what they’re doing. When I was paged by nurses to confirm death, I thought, why are you asking me to do this when the single time I have ever, ever, seen a dead person in my life, is at my grandmother’s bedside ten years ago. You, on the other hand, have seen many come and go.
Why am I pronouncing death when I don’t know what a dead person looks like.
But you do what you’ve been taught, so you look into the eyes, feel pulses, and listen to the chest. Much of the time I still struggle to find the JVP (venous pulse) on a live patient, so I have been spending quite a bit of time looking at necks. And it’s chilling how still a dead person’s neck is – no movement of the overlaying skin with each beat, and breath. And a minute might not be long, but it’s an awfully long time to be standing there listening to a silent chest. You start to imagine hearing this and that.
Although the person’s body is there, you begin to realise that you are quite alone in the room. A person has become flesh with no life. But still, it was once someone’s wife, someone’s mother.
That day, with no one else there or waiting, I guess it didn’t matter that I fumbled and took a long time working out what to do. Then, I was asked to do the same thing today. Except this time, I had seen the patient previously when she was alive. This time, family was there, quietly crying, holding her hand. Was it okay to ask them to wait outside while I confirmed death. Was my silence rude. Should I have said something more. In the end I decided to let them be – the family members had each other to grieve with and a stranger couldn’t bring much to that process.
After that, I found myself crying in a quiet room, with lights off, thinking that hospital is such an unhappy place to be. Perhaps it was the grief of human illness and death that I couldn’t stand. Perhaps I recalled the exasperating patients presenting again and again to the emergency department not because there was a medical issue as such, but because their lives were a mess (or ‘not loved’ according to the anaesthetist). Perhaps more exasperating was staff working who purposely don’t pull their weight. Or, perhaps, it was just that and time of the early morning, when the room becomes cold out of your own fatigue.