Reality

Excuse me for a moment as I have an actual serious post.

Reality of the matter is that people get sick. Very sick. And people die. We don't always know who or when or even why. But it happens. It is sometimes hard to remember this when a day, or a night, goes smoothly. You feel good about what you are doing and that you are helping people. All of that can change so suddenly, however, for you and your patients. 

Two nights ago we finally had a crappy night. I say finally because our 2 weeks have gone pretty well thus far. As soon as we came on we had to put a little old patient on pressors (an IV medication to try to keep the blood pressure up) as well as a BiPAP machine (like the thing people with sleep apnea use) because she was having trouble breathing. Her heart was failing basically. We then had a relatively "un-sick" patient suddenly code. As we are working on him, I receive a call saying our little old sick patient was made 'comfort care' - no more intervention to keep her alive, just try to keep her comfortable. Within 30 minutes both of the patients had passed. The energy, the air, the motivation is sucked out of our team. While we go on with our night, each of us is left to pick up the mental and emotional mess left internally.


I can distinctly remember having to pronounce my first death that first week in July. He too was comfort care, so the death was expected. But I still got a cold chill when the nurse called me to say he had passed. I went and spoke to the family, who was with him when he passed and were mentally prepared. I did the final exam we are required to do, expressed to the family that I was sorry for their loss and asked whether they could use anything, then I walked out of the room with the glossy eyes and an ever enlarging lump in my throat. The sad thing - I don't remember his name. I remember everything else about the story: his room number, the color blanket he had on him, what the family said to me. I can't remember his name though. Is this self preservation? Mental and emotional protection? These questions are too big for me and my little half read blog. They remain important however.


The culture of medicine is to not discuss death. Death = failure. We are supposed to keep people alive. When we do talk about it, we stay superficial. "It is best for her." "He was very sick." Then we leave it at that. Even if that is the case, we don't delve further into our own reactions, beliefs, and feelings. Do we need touchy feely therapy sessions? No. We do need to express it however to stay mentally well. Sigh. Add another thing to my list of things to work on