A Death in the ED

This week I had the opportunity to be involved in the care of a patient who ended up passing away in the ED. A death in the ED is not an uncommon occurrence. This is the place where the sickest patients begin their hospital journey and unfortunately, end it as well. Over the course of my career, I have become no stranger to seeing, evaluating, resuscitating end of life patients and ultimately being a solemn witness to the moment of death.

But for this particular patient, at this particular moment, I stood in the doorway of the room, watching the rise and fall of the patient's chest and observing the shell of their earthly body show evidence of chronic deterioration and now acute cardiopulmonary collapse. I was reminded of the line from C.S. Lewis' book, The Weight of Glory:

It is a serious thing to live in a society of possible gods and goddesses, to remember that the dullest and most uninteresting person you can talk to may be one day be a creature which, if you saw it now, you would be strongly tempted to worship, or else a horror and a corruption such as you now meet, if at all, only in a nightmare. All day long we are, in some degree, helping each other to one or other of these destinations. It is in the light of these overwhelming possibilities, it is with the awe and the circumspection proper to them, that we should conduct all our dealings with one another, all friendships, all loves, all play, all politics. There are no ordinary people. You have never talked to a mere mortal. Nations, cultures, arts, civilizations – these are mortal, and their life is to ours as the life of a gnat. But it is immortals whom we joke with, work with, marry, snub and exploit – immortal horrors or everlasting splendors. (p. 45)

In that moment, I was reminded that I was not looking at just a broken body that reflected the patient’s age and hardships in life. Rather, I was looking at the visible, exterior manifestation of a person and a soul, made in the image of God, and placed divinely here on earth for a specific purpose and a specific time. This was no mere mortal.

As doctors, nurses, medics - or whatever position you hold on the frontlines of healthcare, you have an an awesome opportunity, privilege and responsibility. Every patient you see is a reflection of the image of God with an eternal destination - whether it be the simple ankle sprain, the chronic homeless alcoholic or the frail frame of the patient receiving CPR. You may be the last face they see and the last hand they hold as they exit and this life to enter eternity.

Between boarding and burnout, the last several years in medicine have been extremely challenging for me personally. It seems that my medical practice has become little more than an exercise in pleasing the metrics and managers. From time to time, I think it is helpful to take a step back and remember that medicine is more than just the science. It is more than a collecting and synthesizing data and optimizing outcomes. It is more than just generating revenue for a health system. Medicine is an opportunity to meet people where they are at, to play a small part in their lives here on earth and with any luck have an impact that ripples into eternity.