Friday was an intense day. I woke up at my usual 4:30 (I set my alarm for 4 and get up sometime between 4 and 5) and got ready for work. Walking up to the GI team workroom that morning, I knew it would be a busy day. Friday was my last day on GI which meant I had to get everything organized with my patients in order to switch over to the new team. I had to say goodbye to my patients, sign out all the information to the new incoming residents, make sure discharge summaries were up to date- lots of stuff.
When I shuffled into the team room at 6:30 that morning, I could see from the face of the second year resident who had worked overnight, that something was wrong. He told me that one of my patients had taken a turn for the worse overnight. This particular patient had had a rocky past few days. We were anticipating sending this patient home, but some setbacks had changed our plans. I made a mental note to go see the patient around 7 am. I didn’t want to barge in if they were still sleeping, but I wanted to check on them. So, 7 am seemed like a good time.
At 6:45 the nurse paged me. I called her back immediately and she told me my patient had passed away.
I was shocked. Not only was I not expecting this outcome, but I had not even thought this patient dying was a possibility during this hospitalization. I know this person was sick. But, I’ve seem lots of patients with the same exact diagnoses as this person, and they all made it out alive.
I had to go into the room to pronounce the patient’s death, which was emotionally taxing all by itself. What made it so much worse was the fact that this patient’s family was in the room, sobbing. I had really come to know some of the family members and seeing them so upset was awful. My stomach was in knots. I tried to keep a straight face and not show my distress. I mouthed, “I am so sorry for your loss” to everyone, quietly took out my stethoscope and placed it on this lovely person’s chest and heard nothing. “Time of death 6:50.” I said. I bowed my head, told the family I would come back in a little bit, and again apologized for their loss.
As soon as I left the room I could feel the tears welling up in my eyes. I have lost patients before. I have seen patients die in the ICU. I have pronounced patient’s as deceased before. But, I’ve never cried in the hospital. Friday morning was the first time I cried, back in the privacy of the GI team room. My other residents hugged me and told me it was okay. I was just so shocked this had happened! I felt like it was my fault, like there was something else I should have done.
Losing a patient is often inevitable and always heartbreaking. So much of medicine is about saving or maintaining life, so we take death as a failure. I remind myself that death is part of life, and sometimes death is even better than prolonged suffering. But, it’s still hard 🙁
After that rough morning, we had a LONG day with lots of patients and lots to do. I didn’t end up leaving the hospital until 7 pm which gave me just enough time to run home and change before meeting some girlfriends out for dinner and drinks. We split a few appetizers which included calamari and the BEST nachos!
I basically collapsed into bed on Friday night- grateful for the support of friends and my husband, and glad that another inpatient month was over.
I am always honored to have the privilege of caring for the sick, but I am looking forward to ophthalmology because dealing with the death of patients will be rare.
Have you ever had a patient die? Have your loved ones died in the hospital?
What do you think is the best thing a resident can do in this situation?