reaction to death

[mdsquared]

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While volunteering in the ER today I saw an elderly man brought in with heart problems. He was a heavy man about 60-70 years of age and he went into cardiac arrest. I stood outside the room as the physicians, nurses, & respiratory techs tried to keep him alive.
After 30 min he was pronounced dead. In the final 10 minutes his wife was by his side crying and praying that he would make it.
All I can think about now is how strange my day has been. I have flashbacks of what happened and how at the end his wife called someone and while crying said, "my jimmy is dead, my jimmy is dead."
The doctors and nurses seemed like they didn't even care. After he died they started talking about the cake in the lounge. Is it natural for me to feel a little depressed and sad about someone's death? I'm assuming that after seeing a few patients die I will get better at responding to this. So has anyone experienced something like this?

 

[upitt]

Seeing someone die is a very horrific experience. On top of that seeng somene die with his wife by his side is even worse. Your reaction was very normal. Even though this was a person that you didn't even know you still displayed feelings of loss. This probably means that you care about people and maybe one day you will become a very good physician whowon't get caught up in the doctors lifestyle/money.

 

[gizzdogg]

Originally posted by mdsquared
While volunteering in the ER today I saw an elderly man brought in with heart problems. He was a heavy man about 60-70 years of age and he went into cardiac arrest. I stood outside the room as the physicians, nurses, & respiratory techs tried to keep him alive.
After 30 min he was pronounced dead. In the final 10 minutes his wife was by his side crying and praying that he would make it.
All I can think about now is how strange my day has been. I have flashbacks of what happened and how at the end his wife called someone and while crying said, "my jimmy is dead, my jimmy is dead."
The doctors and nurses seemed like they didn't even care. After he died they started talking about the cake in the lounge. Is it natural for me to feel a little depressed and sad about someone's death? I'm assuming that after seeing a few patients die I will get better at responding to this. So has anyone experienced something like this?

Earlier this year my mother died in the ER while all of the family looked on. It was the first time i had seen anyone die. It really changed my perspective on medicine and death. The staff were compassionate yet still detached. Initially I wondered how the staff could deal with this on a daily basis, and how they could be so casual about it. I didn't feel angry, but just wondered and wondered how they could be so nonchalant about death. I still don't fault them at all for being so detached. It's how they have to be in order to function to the best of their abilities.

I believe your premonitions are correct. I'd bet that they were initially affected just like you were, but became largely desensitized to tragedy over time.

 

[Lochmoor]

I agree, your reaction is quite normal.

But, I do not think that the reactions of the physicians and nurses means that they are "caught up in the doctors lifestyle/money".

I think that they just needed something else to think about. I'm sure they deal with a lot of deaths. If they dwell on it too much, they can get burnt out very quickly.

 

[jcdoc107]

While shadowing a neurosurgeon I had a similar experience. A middle aged woman was flown in with a ruptured brain aneurysm. As the doctor looked at her brain scans he pointed out the massive pool of blood in her brain and said to me in a very upbeat voice "that's death". The family then arrived at the hospital sobbing of course. The doctor talked to them for a few minutes and explained that there was nothing that they could do for her. He then went on with his day like nothing ever happened.

 

[upitt]

That's true. If you get emotional about each patient you will never make it. I remember volunteering and on the second day of being in the ED a man who was shot died. The police said that he was in the wrong place at the wrong time. I watched his mother completely break down after he was pronounced dead. As I watched I had tears in my eyes and was depressed for days.

As you get more experience you will learn to deal with death. It's not that we don't care. With experience you will learn how to manage the loss of your patients or anyone else for that matter. Believe me, it stays with you always. Sometimes you might even have nightmares about it but you will eventually learn how to manage those feelings.

 

[G0S2]

I am a volunteer with hospice. Witnessing death induces a huge impact. Use these experiences as a guide as you become a physician. Certainly, many people will have different motivations during med school. Having experienced the end of a life first-hand will serve you well. Perspective. Never foget it and more importantly, how the loved ones felt at that moment.

 

[jlee9531]

talked about cake afterwards??

i hope at least some doctor came up to the wife and offered his condolences or something...

i hope i don't get desensitized to the point that i dont notice a family member suffer after one of their loved ones passes away...

 

[Herpeto]

I too have been volunteering in the ER for some time now. Throughout this process I have seen several people die and a couple revived. I have never had any emotion toward the situation nor feelings of grief or remorse. This is not to say I don't care about the patients, just that one must be able to detach oneself from the negatives or harsh realities of medicine if one is to survive.

I suppose my thought process may have developed because for two years, on two separate occasions I home cared for my grandparents and helped them to pass at home. The events allowed me to intimately see each of the stages of death and how beautiful it can be.



Herp

 

[Bobblehead]

The first few times you see someone die you'll be quite upset. The first time you have to pronounce the death you'll be even more upset, especially if it's a patient who died unexpectedly. The worst one will be if you think (correctly or not) the death could somehow have been prevented by something you or a staff member had done while in the hospital/ER.

People making the comments about how callous the staff seem are viewing it as a lay person does. You need enough of an emotional separation from the patients or you won't be able to do your job day after day. More importantly you won't be able to provide good care for the patients who are still alive and need your abilities. Empathy does not need to involve coming apart at the seams when someone dies. That's the family/friends' right.

So yes, pronounce the patient, hold the wife's hand, comfort her as best you can, make sure you provide the family a good death and then go take care of your other patients and eat (in whatever order the clock dictates).

 

[drdr2010]

the first person i ever saw die was my own father, in the hospital. and as we turned off the ventilator and waited for him to go, i too was somewhat appalled at how business-like and detached the nurses seemed. the doctor too, although he came to offer his condolences, he seemed like he was just going through the motions.
but then i became a CNA (cert nurse aide) at a nursing home. many, many of the patients i cared for (sometimes the same ones for more than a year) died. and it was my job to clean them up and prepare the body for either the family or the morgue/funeral home to pick up. and at first it was terrible. so hard. i would cry and cry and have a very difficult time performing these duties because i just felt devastated. and i would see their families and i would become upset again. but honestly, it was just so draining and hard on me, that i realized i couldn't have that reaction to every death, or i wouldn't be able to keep doing my job. its not that i stopped caring or that i was no longer saddened by the deaths, but i had to detach myself emotionally, both for myself and for my other patients.
i imagine its much the same for doctors...i can't imagine feeling the pain that i felt when my dad died, or even a fraction of that, every time i lost a patient...it would make the job unbearable.

 

[maya]

Originally posted by jlee9531
talked about cake afterwards??

i hope at least some doctor came up to the wife and offered his condolences or something...

i hope i don't get desensitized to the point that i dont notice a family member suffer after one of their loved ones passes away...

Same here, I hope that I don't become too desensitized. I would think that doctors in the ER would have to be more detatched due to the extremely high levels of stress that they experience.

 

[DSM]

As a paramedic, I see death often. You CAN NOT let it get to you emotionally BECAUSE if you get caught in the drama you can not do your job. You must remain detached so that you can come back and do the job again. If you break down every time someone dies then you won't last long in the medical field. End of Story. I have been doing this for 15 years so I speak from experience.

But being detached does not mean you must forget that you are human. Treat the family just like you would like to be treated and everything is right with the world. Comfort and care are part of the job just like intubating and IV initiation.

Those folks who do not learn to handle their emotions usually find another field to practice. I too, have worked many a cardiac arrest and then gone to lunch an hour later and discussed the menu. Just remember folks........life goes on.

 

[DrBodacious]

Your response to seeing it for the first time is normal, I'm sure I will react similarly. I volunteer in an ER and am yet to see someone die. I did see someone get brought in who wasn't breathing which was pretty nerve racking for me to see. The whole mood of the ER changed when he was brought in.

For some reason, I'm already pretty rational about death however. Death is a fact of life. People who witness death alot are bound to get sensitized to it. They have to, or much of their lives would consist of the feeling you had as you were thinking about how horrible it was that that old man died. On the one hand, it would be nice for your patients if you spent your entire life emotionally in touch with them and their familys, but that isn't feasible for most of us. The fact that doctors expertise can save lives is enough for me when I think about it rationally. It would really tear me up if a life was lost do to neglagence... I'm not looking forward to dealing with that if it ever happens, and I really hope noone dies because of me.

 

[woolie]

One of the first few weeks I was volunteering in the ER a young man was brought in who had killed himself by jumping in front of a subway train just a few blocks away. The same stop I would have to take home in a couple of hours. Anyway, it was about 5:30 pm on a late October Sunday night and in general I find Sunday evenings to be depressing often.

Still, it was shocking to have the body lying there all shift and having everyone in the Department, staff and patients, know what was going on and to also see his effects being slowly taken out of the room by the social worker on duty that night. His shoes, wallet and scratches of scrap paper lying on the counter. Very sad, and we all talked about it. I spoke to alot of patients and was honest and we discussed our feelings about death, suicide, and intimate things like that. I also made a point of talking to the social worker and asking: what should I be feeling, what is normal to feel after this? Debriefing is crucial. After 9/11, the cops and firemen would talk endlessly about the day with each other, and constantly debrief their memories and experiences with others who understood.

Now I work with the homeless in a primary care clinic and it's hard to constantly see people who are basically trying to kill themselves in various chronic ways. But we also have the gallows humour and 'talk about the cake in the lounge.' There's definitely a fine balance between caring and being plowed under. Trauma workers suffer tremendous emotional burnout, as others mentioned above - or they just develop thick skins, which can appear rough to the outsider.

I want to practice family medicine because then you can see death but also birth, which is great.

 

[sgilani]

question to all of you who saw a dying patient and their family in an ER etc...
were there any grief counselors present?

 

[asama527]

It may sound insensitive but you get used to seeing death after a while. It gets to you emotionally at first but then you learn to accept it as an inevitable process. I've seen a lot of gruesome stuff, not necessarily in the ER. At first I was unable to do anything for a few days but the more you see it, the more efficient you become at letting it not get to you.

 

[snowbear]

Ever since one of my close friends, along with another girl from school who I had grown up with, died a couple of weeks after we graduated high school in a car accident, I think I have been struggling with the concept of death. I remember me and my other friend went to visit our friend when she was in the hospital. She was only alive because her parents could not accept her death; she was on life support. It was really painful to see her like that. I knew her as my beautiful and strong friend and I didn't understand how her life could be ended before she was even 19 years old. My sister believes that it was her time to go, but I don't know if I believe that. She had so much ahead of her in life, she would have been the most amazing wife, parent, and leader.

Ever since then I think I have had a hard time with death. I think I am getting better, but still to this day, when I think about the concept of death in detail, I become really bothered. I love life and I am so excited for all that is in front of me with the people that I love. I think it doesn't help matters much that I am not religious and I don't believe in heaven or the afterlife. Hopefully, as I will get older, I will become more at peace with death. Maybe, like I have heard older people say, I will be ready to die and more equipped to witness the deaths of the people close to me.

So when I fell in love with medicine, I was a little concerned about my issues with death. But I am pretty confident that I can detach myself from death. I have seen several dead people in a medical setting and it gets easier on me everytime. I think my problem is just when I start thinking about it too much. I know that becoming a physician is my passion, and I will do what I need to to fulfill that passion. I think like other people have said in this thread, the detachment is like a coping mechanism.

And for MDsquared, as this is the first of your encounters with death in the medical field, I would be more worried about you if you felt nothing for this patient or his family.

 

[Nor2themax]

"question to all of you who saw a dying patient and their family in an ER etc...
were there any grief counselors present?"

When my dad died in the ER they(the doctors) came in to tell us with a Nun and a priest from the chapel.

 

[dowiattp]

i work in a peds er, and ive seen more kids die than i can or want to remember. any kind of death is difficult to deal with, but seeing kids die is especially hard. all the docs/nurses/techs etc i work with are really good with showing compassion and empathy for the families. at the same time, though, i think its hard to really hard to process the magnitude of someone dying given how frequently it happens and how there are so many other sick kids that are still in the ed needing the staff's attention... it's tough, but thats how it goes i guess

 

[TTSD]

It's easier when you don't know the person. Working with the elderly, especially Parkinson's patients.. a lot of times you can see death at work and all you're doing is buying them a little bit of time.

There was this one patient where death was just completely evident in his eyes, his days were numbered.. he was running on borrowed time.

However, it only really hits home when it occurs to you personally and really throws things into perspective.. how quick and sudden everything can be and the words "carpe diem" don't just become a witty catch phrase. You only have so much time..

And in the end you have to ask yourself, when it's been said and done.. are you satisfied with your life?