Time of Death III

This post finishes the thoughts on the two previous blogs.

The feeling is a dull misery. The unexpected death of a patient, and on an operating table, caught my breath. We question whether it was the right decision to operate. We ask whether we could have optimized him better or anticipated more. We wonder whether those obstacles we kept on hitting were inevitable or things we could have avoided. We question ourselves.

But after laboring so long to make happen something that ultimately failed, exhaustion takes its toll. There is a physical exhaustion, the kind that makes you want to get into bed without a shower, and there is an emotional exhaustion, the knowledge that I ought to be feeling something but feel very little.

I mourn for the departed. I struggle to understand what it means to be in an occupation that tries to heal, and occasionally hurts. Sometimes the good attendings commiserate likewise, helping me debrief. In the end, there is a sense that it could not be otherwise, that we did try to do everything. Whether this is true, or just me reassuring myself, I do not know. But along with that thought is a fleeting question of whether we should have given up when we did. Putting someone through pointless suffering and misery is unjustifiable. But at the time, we simply do not know.

It is a truly awful feeling to hold someone's hand and induce anesthesia and be the last person they see and to say, "I will take care of you," and fail to do so. I dwell on this a lot, and I hope that someday this experience makes me a better doctor somehow.