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I stared at Her remains, all of the little bits and pieces.  It was the last day of gross anatomy and I wanted the moment to feel important.  I wanted Her to know what it had meant.  The sacrifice.  As we zipped up the Tyvek bag, I wanted Her to hear angelic voices and heavenly bells.  It was what She deserved; it was what they all deserved.  To hear John Taverner when we placed her into the box, a Magnificat so thick and lofty you could almost see the sound shimmer in the air.  To hear inspiration and hope as we closed the lid, just before everything became silence.

I didn’t hear any of that, and I was halfway home before I realized that I had never even prayed for Her.

I used to think that death was a rare thing because I didn’t know anyone who had died.  It was abstract and unreal, something that happened in movies to make adults cry.  I thought that death was a rare thing until I was eight.  That was when Angela Pollock died of cancer.  She was the wife of a family friend; someone we would see around Christmas or maybe at a summer barbecue.  When I think of her now, I see her picture on the prayer card.  Thick-rimmed glasses and a red sweater.  I’m pretty sure she was smiling.  There were a lot of people at her funeral, and I remember thinking that it must be nice to have so many people be sad you were gone.  I didn’t even know that many people.  Afterwards, my parents told me to pray for her, so I did.

I had a poster on the wall of my room.  It was a picture of an astronaut during spacewalk, tethered to his ship by nothing more than a thin, white gossamer.  It all seemed so delicate.  I wondered what would happen if the filament broke and he just disappeared.  In bed, I would stare up at the poster and say an Our Father and a Hail Mary and a Glory Be.  And then I prayed for Mrs. Pollock, that she wasn’t scared, that she was somewhere good.  I would make the sign of the cross and say an amen.  On most nights I fell asleep before I could finish, and suddenly find myself dreaming of great things, like flying over the ocean, always towards the sun as it sank into the fold of night.

I liked praying for Mrs. Pollock because it felt important, like I was helping in some unknowable way.  So it wasn’t long before I decided to start praying for everyone who died, even those I didn’t know.  I would watch the news and pray for the victims of that fire or the couple who was killed across town.  There was a man two streets over who died of a heart attack in his house, so I prayed for him, too.  The Priest always had a few new names at Sunday Mass, and I would add my prayers to his.  There was even the bird that flew in front of my brother’s car, meeting its maker in a most glorious burst of blue plumage.  I wasn’t sure if there was a Heaven for birds, but I prayed for it anyway.  I imagined my words were like bits of cloud beneath this great collection of souls, dissolving their earthly bonds, propelling them forward, forever into the sky.

And then my Aunt Andrea passed.  Luke got hit by a car.  Frank overdosed on cocaine.  Father George.  Steve.  Johnny.  Nana.  Grandma.  By the time I was 27, I was no longer a stranger to death.  It wasn’t an everyday occurrence, but it certainly seemed to happen a lot to people I loved.

“People die.  That’s what happens when you get older.”

That’s what my uncle said after my Grandma’s funeral.  He said it in such a casual, off-hand way, but I remember thinking he was right.  Death no longer felt rare or important and, eventually, I decided there were only so many souls a prayer could lift.  At some point, I just stopped praying.

Five years later, I met Her in gross anatomy.  Running my fingers over the grey, compact skin, I wondered if She knew it would be this way.  Puncture wounds in Her neck and leg, embalmed blood congealed in Her veins.  Maybe She just didn’t care.  It was easy to think that way.  It made things easy.  Initially, the process felt very removed.  We skinned Her arms and legs, carefully digging through the layers of tissue to identify the clinically relevant structures.  We settled into the routine of seeing Her a few times a week, and indeed, we became fair friends with death.

Then, just before Christmas, I held Her heart in my hands.  We had just cut a flap into the right atrium, and I peeled back the wall, staring into the depths of that great machine, so small and delicate.  I was awed, honored, realizing for the first time the extent of Her sacrifice.  She had given herself over to untrained, clumsy hands so we might someday become doctors and surgeons and heroes.  It must have taken so much courage to allow this to happen, to continue existing in this way long after her last moment.  I wondered if I had that courage.  It would only be right, in a twisted, Golden Rule type of way.  Do unto yourself as you have done to others.  But I don’t know, even now.  Because what if she was still there, her mind or her soul, feeling everything, painfully waiting to be liberated?  It was a horrifying thought that made the significance of Her death all the more evident.  Some wise person had told us that She would be our first patient and our greatest teacher, but She was more, even than that.  We had to set her free.

So we dug carefully through the thin white webs of intervening fascia, watching them dissolve into thin air.  We demonstrated the paths of her vessels and nerves, hewn out of the surrounding tissue.  We categorically identified every structure we could, even removing the lungs, bowels, and brain for deeper inspection.  We were like the ancient Egyptians, sending her soul piece by piece into the afterlife.  At the end, I was left staring at her remains, all those little bits and pieces we placed so neatly in a box, hoping she knew what it meant.

Lying in bed that night, I said an Our Father and a Hail Mary and a Glory Be.  And then I prayed for Her.  Not a prayer of hope, but one of thanks.

I wasn’t wrong.  Death really is a rare thing.  It is a single moment among all those other moments of our lives.  It is the last moment.  When it comes to me, I hope I can pass through the gate with courage.  I hope to hear angelic voices and heavenly bells.  To find myself flying over the ocean towards the sun as it sinks into the fold of night, buoyed by the thoughts of those I left behind.  I hope that somewhere, a child prays for me just before he falls asleep and goes on to dream of great things.

Daniel Coleman Daniel Coleman (5 Posts)

Medical Student Editor

Georgetown University School of Medicine

Daniel graduated from Tufts University in 2004. His subsequent pursuits included everything from cell cycle research to manufacturing shampoo. Medically, his interests lie in emergency and wilderness medicine, infectious disease, and health care sustainability. Daniel is medical student at the Georgetown University School of Medicine, Class of 2017.