“Doctor, Mr M has just passed away. Can you come and verify please?”
I see a lot of dead people. Verifying a death is famously part of a doctor’s job (and it’s not quite as easy as that first episode of Scrubs, where JD takes one look at the body and says ‘time of death…’).
During induction I remember some other more experienced junior advising us to ‘let the dead get cold’, because it makes the job easier if Mrs P is definitely dead when you enter the room. Every horror or comedy film you’ve ever seen will tell you you don’t want to get that one wrong.
But it’s not quite that simple, is it? Even though most people can recognise a dead body, in hospital it’s the doctor’s role to perform a set of examinations to confirm a death. I try not to wait around because doing it promptly means families are kept informed and the death certificate can be written.
What does it involve for me? I enter the room where the patient is lying, perhaps with curtains drawn if they’re in a bay. I talk to them as if they’re awake, in case they are. “I’m just going to listen to your chest”. I listen for two minutes for heart sounds or breath sounds, and feel for a carotid pulse. I look in their eyes. I check for a response to a painful stimulus. I check for a pacemaker. That’s the medical part. Sometimes I can hear my own heartbeat in my stethoscope, feel my own pulse in my fingertips, and wait a little longer in case I’m missing something. I think of my mother, whose worst fear is of being buried alive. I always think of this. I always wonder what are the chances. I place a hand on their shoulder and try to imagine what they looked like as a child, as a person full of life. Not in hospital, not in a hospital gown. I turn away and write in the notes. Time of death…
I see a lot of dead people, so now it doesn’t shock or surprise or scare me. Of course not, it’s part of my job. But I worry about the consequences of so much exposure to mortality. Everyone dies, everyone dies, so will life lose its importance and meaning for me? Some argue that exposure to death makes you value life more. But often I feel it’s just too inconsequential, like a candle burning briefly and then being blown out. What is it that really matters, in the end?