Brought to you by the students of the University of Cincinnati College of Medicine
By Zack Callahan
Arthur came in, jaundiced and dying. His rectal temperature was 105°F degrees, confirming the nurses’ suspicions that the man was septic. In anticipation of such an event, we prepped the room for intubation. Seconds before the procedure would start a health care proxy called the ED. After a few minutes on the phone, the doc said “DNR/DNI.” Most of us were relieved; we had seen many cases where the sick and dying died being poked and prodded. It was a strange feeling. If Arthur coded, we would do nothing.
I held his hand while he shook violently. We think the fever caused his tremors but we couldn’t know for sure. At one moment he looked up at me and I said, “Hi Arthur.” He said, “Hi.” I asked him how he was, what a stupid question. He said nothing; it was as if he had used all his energy to return my greeting. Hours later, I would regret that Arthur’s last words were a useless colloquialism and even worse, directed to some kid rather than a family member who loved him.
After five minutes I was called off to draw blood, to bring a patient to x ray. I told Arthur I would be back in a bit. When I got back from x-ray Arthur’s curtain was closed. It took a little while for me to realize he had died. It wasn’t his passing that left me unsettled; I have seen many people die. I guess I just thought he had more time. I thought I would get to go back in and be with Arthur for a little longer; I was simply too late.
So why do I still remember Arthur when I’ve forgotten so many others?
I believe it is because my experience with him was not remotely medical; he was a DNR/DNI after all. Medicine is structured and the answers are not always clear and easy but they are thankfully emotionless; it is a cold list of steps. Without a callous procedure, medicine would be too sad. In treating Arthur, treatment was completely absent from the situation; I was left with a person, not a patient. My hands were not interlocked, primed for compressions, nor slapping stickers on a cold body for an EKG. They were simply holding his frail hand as his last seconds passed.
I will always remember Arthur as the first person, after so many patients, that I have seen pass away.
On the passing of a human being.
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