People often comment about how close we are to death, as healthcare professionals. When I first started into medicine, I assumed that that constant exposure would make death easier to deal with- whether myself or those close to me. I thought it would be like exposure therapy in psychology, overcoming fear by incremental, gradual introduction.
Instead, it has done the opposite. My experience in medicine has made me feel infinitely more removed from death; paradoxically, because it is so routine. The problem is that I've been conditioned to assume that it's never me or my family. Death is always in the controlled environment of a hospital, and it's usually not unexpected or sudden. I guess my mind has developed this corollary that if my family isn't in a hospital, then they are immune to death (but when I hear someone close to me has been taken to the hospital, I am immediately overcome with anxiety).
I'm always surprised to hear from others that a death was unexpected (of course there are exceptions, like a car accident)....
But then again, healthcare professionals don't always paint an accurate picture of the scenario. We assume the family and patient understands the severity of the situation. When a patient with terminal cancer comes in with a terrible infection and have to be put on a breathing machine, or have developed an infection like pneumonia, we assume that the family understands that the end is near. Doctors, in deference to the patient and family, use soft and gentle words, like "we're doing everything we can," or "we're just waiting for the oxygen saturation to start coming up, that'll be a good sign," because it's a lot harder to say something like, "Even though they were fine yesterday, pneumonia in an already-sick patient is usually fatal, and the likelihood of recovery is low."
But not being realistic and definitive, at least broaching the possibility that their family member may not survive, often results in unexpected tragedy. "Aunt Ruby had pneumonia, and came through just fine with some rest and antibiotics!" and then questions come up- why couldn't the doctors prevent a death from something so common like pneumonia, or at least predict the outcome? It it was me, I would want my family to be aware, so they could visit or call, just in case.
Sometimes it's because the doctors don't know for sure. Sometimes it's because we know that telling someone they only have three months to live, when they really had six months, may condemn that person to only three months because you've created a mindset.
I digress already, proving my point. It's funny that as you mature, you lose the concept of teenage infallibility. I'm fascinated by children- they literally cannot understand the concept of death or permanence. I feel as though perhaps, I have circled back around, which I will justify as a necessity for my ego's sake.
Why the sudden morbid fascination with death, you ask? Driving home this morning, I passed a nasty two-car accident. The ambulances long gone, only a few police officers remained. One of the cars was covered with a tarp, and then I noticed a nondescript coroner's van. Rare moments like those shatter my ridiculous illusion of immortality- I always think, that could've been me.
Death in the hospital either happens too quickly to necessitate deep reflection, or too slowly, in which case we are preoccupied with making the patient comfortable. There is rarely any middle ground.
As such, I am no more familiar with death than before I entered the medical field; in fact, I think I dread it more and understand it less.
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