Taking Death as My Teacher

I didn’t want to watch someone slowly die. 

I was there to save lives. But for some reason I was the only nurse available that day. I didn’t volunteer; I was voluntold. 

I didn’t resist my charge nurse’s instructions because my heart went out to the dying man’s wife and children. He had been in a severe motor vehicle accident and had significant brain trauma. The only thing keeping the patient breathing was our ventilator. The injuries were beyond surgical intervention and the doctors wanted us to pull the plug.

This is what they call a “compassionate extubation.” For the lay people reading, it’s when we remove the breathing tube and allow the patient to pass naturally. Normally, this happens in the Intensive Care Unit (ICU) where there are more resources and staff to assist families. Unfortunately, there were no ICU beds available so it needed to happen in the ER.

I had never really learned how to properly comfort people. I was still young– I had just turned 30. I had been part of the resuscitation team for four years and had already experienced numerous cardiac arrests. Death was familiar. But this was different– it was very intimate, very personal. I had to guide the family through watching their loved one die. The respiratory therapist came in and removed the endotracheal tube and then we waited for the inevitable.

I encouraged the family to talk to the patient because I do believe that hearing is the last sense to leave us. The patient’s breathing slowed. 

“God damn you.” 

Tears were trickling down her wrinkled face.

“You promised that we would grow old together. We were supposed to go together.” 

The breathing slowed to a stop.

She paused as the breathing turned into spasms, allowing in a sliver of hope that maybe he was going to make it after all. My spirit knew what was happening, but I had to explain the physiological process of progressive organ failure in a simple way. 

“The body has several backup systems to keep us alive and it goes through each one until there are none left. These spasms are one of those backup systems.” 

As the spasms ceased, all eyes flew to the heart monitor. The heart rate slowed. Everyone in the room took a deep breath and I could feel hairs raising all over my body. The soul was leaving the man’s body and he passed right by me. It was a gentle sensation as if saying “thank you.” The heart monitor went flat. We called the doctor and she confirms the absence of breathing and a heartbeat. 

The patient was pronounced dead. 

I tucked all the emotions and memories away in my mental filing cabinet so I can return to work. This is a normal process that I repeated until I could no longer feel anything when someone died. I lost a part of myself that used to be excited for life in order to do a job well. I eventually burned out because death waits for no one. 

Death can be very unexpected. We can’t really prepare for it. At the same time, we don’t want to focus on it too much because it scares us. Instead, we’re asked to focus on life and what it means to live. We’re all stuck on the same rock floating in a universe surrounded by an infinite number of stars, planets, and moons. In this great expanse, our problems seem to not exist in comparison to the bigger picture. But we all have limited time on this planet. Each experience is a blessing. 

Death, grief, and pain are all a part of life. Like the decay of trees in a forest and the fire that burns them all away, death makes room for life to continue. Death really is an angel. I contemplated that experience for a long time and I refused to let it go until it blessed me. One day, as if the angel of death whispered in my ear, I found my blessing by emptying all the mental filing cabinets that have filled up over the years– because I had no more room.

I released all my guilt, regret, and pain from all the people I could not save. I did not realize the weight of the burden I was carrying with me. ER nurses pride themselves on being emotionally bulletproof and remaining calm under pressure. But where does all that emotion go? There was only so much emotion and memories I could hide in my mental filing cabinets. I would inevitably have to process them all and it happened to me all at once. In this period of reconnecting with my own emotions, death taught me that I must let go of the past so I can continue to live. By taking death with me, I was also slowly dying inside. This was the reason I could no longer feel anything when someone died. When I forgave myself for failing to save them and remembered the “thank you” I felt, my spirit was reborn.