One of my patients died today, the first time that I was actually around for such an event.

He was kind of a hopeless situation from the time he came in a few days ago, but we gave it our best shot. His family knew the prognosis was bad, and today when some tests confirmed that he had basically no brain function left, they agreed to withdraw care. I talked to them from the beginning, putting out the likelihood that he wouldn’t recover and that a decision would have to be made. Today I was trying to hide, letting subspecialists talk to them, but of course it wasn’t that easy. “Alice, we finished our discussion, now they’re asking to talk to you.”

The family seemed like great people, a strong family. They had a spokesperson who asked questions, and then announced their decision. I told them what we would do (having just carefully checked with the nurses, since I had never seen such proceedings myself). After the decision had been confirmed several times, we took them back to the room, and the nurse and I took out the breathing tube and left them alone together. I guess I didn’t really need to be there for that step, but I felt like he was my patient and I didn’t want to hide anymore.

I got in a corner and cried. I don’t know why, it was the right thing to do, and the family knew it, but they were so sad to lose their father, I couldn’t help it. Some time I should figure out at least how not to cry when I’m talking to the family, it doesn’t really help the situation.

About half an hour later I came back to check, and the nurse was printing an asystole strip off the monitor. So that was that. It took me three tries to fill the death certificate out correctly. (I have no idea how I’ve gotten to the twelfth month of internship without having had to write a death certificate before.) And then the coroner’s office wouldn’t answer their phone, and I had to keep calling and calling.

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