I read How Doctors Die: It’s Not Like the Rest of Us, but It Should Be with great interest because the subject has been important to me since I became a nurse. Like many Americans, I had almost no exposure to death or to corpses. I’m blessed with an amazingly healthy family, and very few deaths combined with our society’s sanitizing of death in general landed me in nursing school in my thirties with only one viewing and funeral under my belt. I had never even seen anyone who was actively dying.
I vividly remember the first time I saw someone die; it was during nursing school clinicals. I cried in my car; it affected me that deeply to be present when a person left this world. Those were hospice clinicals. Then I spent all my time in critical care and trauma, where the deaths got violent, sudden, and unexpected.
The part I had trouble accepting was not the deaths. I knew that in these practice areas I would of necessity contact a lot of death. It was the violence involved in most of them, and I do not mean the violence leading to the event of the dying, but rather the violence we as medical professionals inflict on the dying. Dying in a hospital is invasive.
After I witnessed my first code blue, I couldn’t stop telling everyone I knew how awful it was. The cracking bones, chipped teeth, limbs jerking with shocks, and pale nakedness of the patient haunted me. People say things like "I hope I die in my sleep," not "I hope I die with a tube scraping down my throat and my ribs breaking with the force of chest compressions." The invasion continues with many people, who may also have a tube put in their bladder, another one down their nose of throat, and an assortment of IVs. The really unlucky may get a needle drilled into their bone. These things are all painful.
If all this activity resulted in a series of patients walking out of the hospital to lead productive lives, I would feel different about it, but I can remember only one such outcome. The rest of the time the end result was a corpse battered and invaded by medicine or an alive but soon to be dead patient sent to the ICU for a few more days of suffering, often with another few rounds of compression, shocks, and drugs.
It does not surprise me, therefore, to learn that the physicians ordering this treatment opt against receiving it themselves. I don’t want that. I don’t want anyone in my family to have it. I don’t even want to be the nurse involved with it anymore. It’s just too depressing for me.
I understand why physicians and nurses hesitate to suggest alternate courses of treatment. The moment when a family realizes that a decision must be made is pivotal in that family’s history, and no one wants to lead families into a decision they are not comfortable with. However, that is not to say that we cannot educate them, just as we would about any other procedure or disease process. We can answer their questions honestly. It is my hope that such education will put a stop to the current death processes in this country.