Watching Someone Die

I watched a woman die a few weeks ago. I wrote about it in my journal. (All personal identifying info about her has been taken out.) Here it is:

I have never seen anyone die so fast. One minute she was awake and crying in pain and fear; then a moment later she was dead. It is so strange that after years of being in medicine seeing a death would shake me so much. Usually I see people die slowly and see it coming far in advance, either that or I am called to a "Code Blue" when the body is already in collapse and thus a person's death is just a mechanism that I am combating. This woman is the first person I ever watched die suddenly and unexpectedly.

When the nurse called me saying she was having chest pain, I knew I needed to get there quickly since she was old and had a known heart problem. But she was in the hospital for an unrelated problem. I didn't imagine I would be the last person she would ever see. She was afraid. I think she realized she was dying before I did. In retrospect, I'm glad that I took a moment to take her hand and tell her we were going to take good care of her. I did take good care of her. I did everything right, but nothing worked. I had been with her only a couple minutes when I saw the EKG waves change on the monitor above her bed. Only then did I realize how bad the heart attack was. Most of her heart muscle had just quit. I ordered the nurses to give medicines and get equipment but none of it was any use. I remember asking, "Maam, please take a deep breath" and realizing she wasn't breathing at all. The nurses and I felt for a pulse, but it was gone.

She had a DNR (Do Not Resuscitate) order. Part of me wished I could run a Code Blue, not that I could have made any difference in someone her age with a heart so severely damaged. I was glad that I wouldn't have to hear her ribs crack with chest compressions, but in some secret way a Code would have helped me. It would have given me a chance to keep working, to keep analyzing the mechanisms of her cardiovascular collapse.

Without work to do all I could do was watch her; watch as the pink warm flush went out of her cheeks. I could only look a her as a person: a woman who thirty seconds earlier I had told not to be afraid. A woman who had lived and loved and feared for many years that had suddenly ended. Looking at her as a person is frightening when she is a stranger who has just died under my care. I never even knew her, but I loved her then, because I thought no one should have to die without someone who loved them there. I almost cried in front of the nurses.

I closed her eyes, and pronounced her dead. Before that night I had always thought the idea that life is "fragile" was a bit of an overstatement. I had been amazed at how stubbornly the dying body could cling to life. As I watched her die I realized how fragile it could be. It was just one breath between her pleading look to me and the blank eyes that I saw when I asked her to take another breath that she could never take. She was gone in a second.

I helped the nurses clean up. We removed all the medicines and oxygen tubing and pulled the sheets back over her. I straightened her hair out of her eyes. I wanted her to look beautiful for her family when they arrived. As my hand was on her forehead I silently repeated the blessing:

"The Lord bless you and keep you,
The Lord lift up His countenance upon you,
And be gracious to you.
The Lord cause His face to shine on you,
And give you peace."

It is a blessing Christians have spoken to each other for centuries. I only realized now that it is about heaven.


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