At the end of a long evening shift, I climbed a few flights of stairs, to see dead people.

At my hospital, during the evening/night, the admitting physicians call the Emergency MD who is on, to go make declarations of death if needed (so the primary MD can stay at home).

That evening, two patients passed away on one of the wards.  At 1 a.m. I finally made it up to their rooms, and entered each quietly and with respect.

I have to admit, I am always a bit trepidatious when entering a room with a dead body. It’s a weird feeling, to be in a space with the shell of a person, knowing their soul has probably moved on. For each patient when we declare death, the physician must listen for breath and heart sounds, check for pupillary reflexes and get a general impression of the patient’s body.

One patient I examined was an elderly man, and I made sure to close his eyes after I finished. The other patient was a bit more difficult for me. It was a young man whom I had actually admitted to hospital three weeks ago, a gentleman with developmental delay due to cerebral palsy. When I entered his room, his body was covered completely with the white body bag and a blue sheet. It looked like a person hiding under a blanket, and you can imagine how creepy that is when you are alone in the room at 1 a.m. with a corpse. I examined him and exited the room as quickly as possible.

Declaring a patient dead is something we as physicians are taught how to do. I still remember some of my first experiences, as a medical student on the ward. I think I will always feel that discomfort, of being in a room with Death.

Death is an unknown, unknowable entity that our patients escape to when they have had enough of living and need to have their suffering relieved.

It is a place, or it is a being, or it is a state of being.

Whatever it is, Death is a physical presence in the room with me when I examine a patient who has passed. I feel Death looking over my shoulder as I listen to a soundless chest, open shut eyes; it is as if I am interfering with the process.

I tell Death, I am not here to cheat you. I am here to acknowledge you and give you custody of these souls. Then I cover them up, close their eyes, say goodbye and walk back out into Life.

This discussion with Death will always remain a part of a physician’s life, part of my own life, and I accept the role because in such a way I accord a final respect to my patients.

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11:20 a.m.

 

Sitting in a coffee shop

Rain, wet snow outside

Earlier this morning I sent you on your way

With a touch on your cold skin

Closing of your eyes

Covering your face.

 

I walked down the hall to you

Quiet steps

Knowing what was to come

A little scared

Ready to do my duty

Give you closure.

 

You lay there under a sheet

In a white plastic bag

Skin mottled

Mouth open

At peace

After so long.

 

I remember you

Coming in to my department

In pain

Unable to care for yourself

A prisoner to a body

A gift not fully given.

 

Born without oxygen

Your brain changed

No longer promising

Your life became so hard

But now you are quiet

You wander far away.

 

I look up at the clock

A crucifix above

Must have calmed you

I listen to an empty chest

Wish you a safe journey

Cover you again.

 

Down the hall

Another, I approach you

Older, so old

Ravaged by disease

Now you sleep

I close your open eyes.

 

I sit at the desk

Write the certificates

Attest to your deaths

Attest to your new journey

A final note in your chart

And I can’t help but imagine.

 

I write your name

I write your parents’ names

I write your wife’s name

I write your address

Where you lived your life

Where your story was told.

 

I finish your story

I sign the papers

Close the chart

Put away my pen

Take off my stethoscope

Wash my hands

Say goodnight.