Abstract

As the patient drew her last breaths, with her daughter at her bedside, and the curtain closed across the room, my resident, whom I will call Emma, talked me through what was happening. She explained that the patient's only hope for survival had been surgery, yet surgery would surely have killed her. Emma talked about the different ways different families approach withdrawing the level of care provided in the intensive care unit, allowing a loved one's death. She talked about how hard it is to leave behind everything that happens in this job when she goes home. An intern arrived to make the declaration of death, and Emma encouraged me to go back into the patient's room for this. I placed my stethoscope on the patient's still chest, confirming what we already knew to be true. Death was palpable in that room, and my response was visceral. I did my best to leave the ICU calmly and then ran down five flights of stairs to the hospital chapel and sobbed. When I returned, Emma could see that I was shaken. “It's human,” she told me. In the afternoon, I felt the deep tiredness that I always feel after really crying. In that haze of emotion, I wasn't sure quite how to respond when Emma's next activity for us was to find a patient who needed an arterial blood gas