The Passing

An unfortunate accident, and a man loses nearly all his brain function with no meaningful chance of recovery. Artificially supported, the room hums with the sigh of the ventilator and the beeping of alarms. The blinds are shut and blankets are pulled up high. We talk in hushed voices and bow our heads. Finally, the family decides that it is time to withdraw care. I am on call the day he passes, and the medical student and I enter the room. I take my time, and listen to the family, listen to their heartbeat, listen to their breaths. I look at the patient; I want them to know it is okay to look at someone who has died. I offer tissues. I speak clearly, and genuinely, for this man has affected me as a caretaker. I am sorry for your loss, I say. I meet everyone else who has been central to this man's life. I hear their stories and squeeze their hands. Then, I must do my examination. A little sheepishly and with a preface of formality, I say his name and shake his shoulder. I apologize to the patient as I shine a bright light into his eyes. I watch for chest rise while my hand is on his wrist, still warm. Then I take my stethoscope and set it on the chest. I hold that position for a moment, close my eyes, hold my breath. Then I look up at the family and again, offer my condolences. I tell them that now is the time for them to reflect. I tell them that I have housekeeping to do, things like asking for an autopsy, contacting the donor network, notifying the coroner. But I will do these things later, because now is the time for the family to be wife, brother, son, daughter, friend. I tell them that they must take care of themselves. And then I end as I have decided I will always end when I declare a death and there is family: with a poem. I haven't found the perfect poem yet, and so I choose Yeats because that is one of the two poems I have memorized. For me, poetry is healing, art, humanity, transcendence. I do not know if the family felt the same way, but I needed some healing, art, humanity, transcendence. I indulged myself, and they thanked me for that.

HAD I the heavens’ embroidered cloths,
Enwrought with golden and silver light,
The blue and the dim and the dark cloths
Of night and light and the half light,
I would spread the cloths under your feet:
But I, being poor, have only my dreams;
I have spread my dreams under your feet;
Tread softly because you tread on my dreams.
-William Butler Yeats