Five years ago, when I heard for the first time that a patient of mine had died, I was at home. I was a sub-intern on my wards rotation, enjoying my weekend off, when the text came to me from the intern. “He became air hungry, and he passed. I’m so sorry.” Air hungry. I cried. I knew it was coming, but I was disoriented. Premature death, the gravity of loss.
From friends and family not in healthcare, I’m often asked the question, “How do you avoid taking it home with you?” I’ve turned it over again and again.
Death is now a regular part of my life, and I am often in the room when it happens. Sometimes it is expected and peaceful. Hypercarbia, a deep sleep. Benevolent. Family gathering and saying goodbye.
Other times, it is more structured, almost procedural. Family thinks it’s time. Nurse and respiratory notified, fentanyl and Ativan on hand, tube to be pulled at 2:30.
Still other times, it is chaotic, frantic, sudden. A 20-something losing her pulse in the observation unit. A shrill scream, alarms blaring, her friend flinging herself onto the exam table, wailing, as my colleague pulls her off of the bed and out of the room. Me at the front, an intern, totally green, calling out time to pulse check.
I am in the room, and then I am not, on to the next patient, the next mundane task or familiar crisis. These days, I’m rarely disoriented.
Not taking it home, truthfully, has become something more natural. It is a skill I developed without trying. The job demands it. I can hold a patient’s hand, be fully present with them, and moments later be fully present where I’m needed next. I haven’t consciously avoided taking death, pain or tragedy home with me, nor am I numb to it — my skin has just learned how to get close to a flame, to feel its warmth, without burning each time.
These days, I nurture the warmth from these flames by trying to take it home on purpose, to feel it again, disorient myself a little, imagine all the precious life I witnessed too late. The body, in its adaptive way, attempts to protect us from what can cause harm. The spirit, in its adaptive way, reminds us that the weight of caring, of grief, of bearing suffering is the price, is the painful reward, of life in color.
What a privilege to pay. What a privilege, a worthy practice, to light candles in one’s home.
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