Nautilus

What We Get Wrong About Dying

My first exposure to the death of a patient came during my third year of medical school, in Israel. It was my first clinical rotation, which happened to be in internal medicine. Tagging along with my mentor, a senior physician to whom I had been assigned, on his morning rounds, we entered the room of an elderly woman who was critically ill with an antibiotic-resistant bacteria in her urinary system. The infection had spread throughout her frail body and was now wreaking havoc on most of her vital organs. Observing her for a few moments as she lay there unconscious, he said, “She’s almost at the end.”

I scrutinized the woman’s face, her breathing, the digital readouts of the instruments, trying to understand what signs he was so brilliantly interpreting. To me it seemed like voodoo, as though through some dark art he was able to peer into her very soul.

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Assuming that with nothing more to do here we would move on, I began to back away toward the door. But he surprised me by pulling a chair up to the bedside, sitting down, and taking one of the woman’s limp hands in his own. I realize now that in addition to providing her with the comfort of a human touch, he was also probably assessing her pulse, feeling her skin growing cooler, judging the blood flow to her extremities. But at the time I saw it simply as a kind human gesture, all the more startling because, though so simple, it struck me as a profound part of what it means to be a healer. Even though I was only a medical student, I was already so lost in my books, so focused on physiology and on memorizing for tests, that I had forgotten for a moment what I was really training for.

“She has no family here,” he said. “Never forget, if you accompany your patients only until the battle is lost and they are dying, if you abandon them at that point and leave them

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