Death Is No Crime
Why — why did you die? / Your soul took to the sky / without a conscious goodbye
Why — why did you die? / Your soul took to the sky / without a conscious goodbye
There is a fine line between medicine and mortality: give too much and it can kill someone; give too little and even that could kill someone. We show up to the hospital with the intent to save lives, and anything that deviates from that goal is seen as a failure of the system, or, at times, of ourselves. However, over time, we come to learn that there is an in-between where we are at once trying to preserve life, all the while embracing the idea of human mortality.
In the pediatric ICU, a call was received from another hospital to give sign out for a patient already en route. The child being transferred had experienced a traumatic brain injury. The child was intubated after receiving every sort of therapeutic management imaginable in a desperate attempt to salvage any remaining brain function, but the prognosis was dire.
With a growing interest in geriatrics, I began to wonder what resilience looks like for elderly patients, who unlike children, present their life trajectories to physicians much later. This is perhaps challenging and even uncomfortable to discuss for those who perceive resilience as a long-term goal — overcoming significant barriers in order to improve over time. Resilience may not seem as relevant for elderly patients who may be nearing the end of their lives.
Yours is the name I carry on / You were the first I mourned when gone
Mr. T did not smile at me. No, I didn’t think it was because he was mean or anything; in fact, he was polite and had quite a calming voice. But honestly, it was hard to read someone’s facial expression behind a mask — at least during the first few months of the COVID-19 outbreak.
20 / still / except / her chest rising, falling
A classmate of mine committed suicide a few weeks ago. Though I’ve heard the harrowing statistics about physician and trainee suicide rates, to be honest, I never expected to personally encounter such a tragedy. The small classes at my medical school allow for a strong sense of community in which we all know each other, celebrate important life milestones, and happily reconnect when we’re together after clinical rotations scatter us throughout the hospital.
The first thing I notice are his boots. He’s still in his street clothes, having just been admitted. He looks thin, emaciated — his clothes hang off him, shirt collar drooping down from his neck like peeling paint. His boots, however, seem to fit him properly. They look warm, well-worn but sturdy, like they have weathered a hundred bitter winters and could withstand a hundred more. For some reason, this comforts me.
I no longer feel alone the way that I did the first few weeks of dissections, because now I recognize that my peers were sectioned off at their tables also worried that they were losing their sensitivity, that they weren’t good enough to belong, and they didn’t know how to cut into a person. I wish that I had known what my classmates were thinking and feeling during the anatomy course.
Why would someone choose to donate their body to medical education? We have a dishonorable history in medicine of illicitly sourcing cadavers for dissection: robbing corpses from graves, murdering people for their bodies and salvaging the unclaimed dead from city hospitals and morgues. Today, we call the bodies we learn from “donors” instead of “cadavers” to honor their autonomy and personhood, their choice to be in the room.
It is the day before the first anatomy lab for the first-year medical students, and a single professor walks alone, up and down rows of tables laden with 26 naked, embalmed bodies. He silently shares a few minutes with the donors, a private thank-you. Soon the donors will be covered in white sheets, and the students will tentatively spill through the locked wooden doors of the labs, a rush of anticipation, teamwork, questions and learning.