10:56 – The Minute a Patient’s Life Ends and a Medical Student’s Life Changes

By Rachael D’Auria

The hierarchy in medicine, dark humor used to cope with difficult patients, and embarrassment of not knowing answers to endless questions being thrown your way are some of the many horror stories students above me have attempted to prepare me for. However, no amount of preparation could prepare me for witnessing my first death.

As I watched the residents add notes to patients’ charts, an announcement over the loudspeaker made all the physicians abruptly look up from their computers. “A 79-year-old male is being transported to the ER in a full code.” Immediately, residents, nurses, and attending physicians started prepping the trauma bay, as I, a rising second-year medical student doing clinical research in the emergency department, attempted to stay out of everyone’s way. I squeezed myself into a corner of the trauma bay and made sure I was not blocking any important machinery. The trauma bay erupted with activity as EMS workers rolled the patient into the room while administering CPR and rhythmically squeezing the ventilation bag. He was quickly moved onto the trauma bed and the CPR machine continued chest compressions. The patient’s wife sat near the room’s entrance as the team administered epinephrine, calcium chloride, and bicarbonate while attempting to intubate him.

Every few minutes, a nurse called out “pulse check,” and the resident briefly turned off the CPR machine. The room held its breath with anticipation for a returned pulse, but the resident would respond, “No pulse.” Every time I heard this, my spirits declined as I stole a look at the patient’s disappointed wife. I watched the patient’s wife text family members, the physicians’ hopeless looks after administering another medication, and the machines showing no cardiac movement. After 50 minutes of the pounding CPR machine attempting to revive this patient, the resident and attending talked to the patient’s wife and described what they had done and the poor prognosis. Ultimately, they turned off the CPR machine and called out, “10:56,” and silence took over the room. While I have seen family members in open casket funerals and cadavers in the anatomy lab, I had never witnessed someone pass away before 10:56 a.m. on that Monday morning. The nurse called for a moment of silence to appreciate the valiant efforts of the team, and then the medical team filed out of the room and carried on with their day.

I felt noticeably sad for the remainder of my shift as I grieved this patient I had never met. I felt guilty for feeling this way as his wife held his hand to say her goodbyes because I played no role in his medical care nor did I know this patient. Even though the medical team carried on with their day seemingly unaffected, I imagine many of the caregivers in that room felt the aftereffects of witnessing a passing of a life throughout the rest of their day. As I processed the passing of this man’s life, I realized the importance of building an emotional attachment to patients and allowing myself to address my emotions no matter the duration of a patient interaction or my role in medical care. I will carry this lesson forward in my medical education, as I inevitably am forced to cope with countless tragedies.

Rachael D’Auria is a second-year medical student at Drexel University College of Medicine. She is passionate about bioethics and hopes to continue researching ethical dilemmas occurring in patient care settings throughout her clinical years.

One thought on “10:56 – The Minute a Patient’s Life Ends and a Medical Student’s Life Changes

  1. Beautifully written. Hope the feeling of guilt has been assuaged. We all have different roles at different times but you were connecting within the shared humanity here and that is admirable. Awareness of the emotions we experience which can be uncomfortable, sad, or sometimes quite negative and having coping strategies for processing those emotions is part of your professionalism and kudos to you for recognizing this and bringing your humanity to this work. Carry that with you, have compassion for the patient and the family and for yourself, and take a moment to breathe and honor a life that has passed. You are well on your way and your patients will be the lucky ones. You may find this piece on a medical student’s first patient loss “Loss of my Elderly Patient” as a rite of passage of interest – https://www.ncbi.nlm.nih.gov/pubmed/20353317. Thanks for sharing with us and best wishes for success in your medical training.

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