Pronouncements, and the like....

I walked into the hospital Monday morning after a much-needed Sunday off, not anticipating - as no one would - that my patient had a stroke hours before leaving him unresponsive. But that is exactly what happened. Discouraged enough, I drudged on to see my next patient, a sweet elderly woman, expecting to be discharged that morning since her recent cardiac procedure was without complication. My heart sank again after I learned she spiked a fever overnight, was short of breath, and had some increased cough. I hoped it was simply a charting error, a poor use of terms, and her history of chronic bronchitis all coalescing to present as some perfect storm, rather than the more plausible explanation of hospital-acquired pneumonia.

That was Monday.

Tuesday brought overnight call - the myth-like 30hr workday that becomes my reality every four days. Tuesday also brought my first pronouncement. Late into the night - about the time you wonder if your supposed to say morning rather than night - I got a text page informing me that my patient had died and I needed to come pronounce him. I don't know how long I stood motionless in the hallway, but I suspect it was pretty close to the eternity it felt like.

I feel a certain level of comfortability with death. I have had a few deaths in the family. I have seen numerous dead bodies in my profession. As a student I accompanied my resident when he pronounced a patient of his. I even spent two months cutting through a dead body four years ago in the name of education. Yet, at the same time, when encountered with death I notice this wave of emotion that perpetually surges through my mind - as if it was something so completely novel to me. I felt those very same emotions once again Tuesday night. I proceeded to my patient's room, walked in, and found him as one would - supine and motionless. I snapped out of my haze quickly enough to perform the necessary steps in a pronouncement, then stood there for another few minutes staring. I don't know what I was looking at, or for, or whatever. I found myself curious of his last thoughts. Was he happy? Was he in pain? Did he know Jesus? Did he even know what was going on?

Surreal doesn't even begin to describe it. This was someone who entrusted his medical care - nay, himself - to me. I couldn't help but feel I had failed him in some way. Was there something I forgot? Could I have done something different? Of course those reading think, "you did what you could, it was his time," "you can't save everyone," or some other trite derivation. But you have no idea what its like. You have never stood next to the bed of a person who used to be your patient.

I was only gone for one day.