How Do You Deal With Death All the Time?

By Shannon Tapia

My husband the Anesthesiologist came home one evening solemn, affected, not himself.  His patient died in the recovery room.  It was sudden, unexpected for my husband, and despite the team’s swift efforts and perfectly executed code, the patient died anyway.  It’s relevant to note that his patient was an almost 90 year old man with significant Congestive Heart Failure, probably Chronic Kidney Disease, and complete occlusion of one of his carotids who sustained hip fracture and thus required the surgery to pin his hip for both healing but also comfort.  This is the ultimate Catch 22 in medicine (or at least in Geriatrics).  Someone who really should not be having Anesthesia or surgery due to their life-threatening chronic medical conditions has an accident and now requires a surgery to make their remaining life bearable.  My husband and the surgeon delivered the bad news together, and as the patient’s wife understandably fell apart, my husband cried in front of patients (family) for the first time, ever.  As we processed this together, he asked me, the Geriatrician, “How do you deal with death all the time?”

I won’t pretend to have all the answers.  However, I don’t think my husband or any doctor is alone in needing help or any tips at coping with death. So here are some ways this mother, family physician now Geriatrician copes with death, an ever-present part of Geriatric medicine…
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The Aftergift

“… and maybe then you’ll hear the words I’ve been singing;
Funny, when you’re dead how people start listen’n…”
If I Die Young (2010), The Band Perry

By Michael Dauzvardis

It was in the fall of 2015 that I received a call from a Mrs. Jones.  She went on to detail how her husband, Robert, had died from cancer and donated his body to our anatomy lab in 2006.  She further explained that she and her children had finally come to terms with his passing and now, 9 years later, were finally ready to spread his ashes at the family cemetery plot.  She stated that she wanted to hold a ceremony and perhaps have the students that worked on her husband write something about their experience that could be read at the service…
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Lessons Learned from a Beatbox Heart

By Tim Lahey

Two days ago, Jimmy stuck a used needle into the soft skin of his forearm, and released 20 milligrams of black tar heroin and a bolus of bacteria into his blood.

The bacteria floated from vein to artery as he nodded, eventually sticking themselves to the ragged edge of his aortic valve.  There they multiplied and burrowed until each systole whipped a two-centimeters of snot back and forth in his atrium.

Fevers came first, which Jimmy ignored while buying more black tar at a rest stop on I-91.  A day later, little red stigmata appeared on the palms of his hands as plugs of snot lodged in small vessels there.

When he couldn’t breathe, Jimmy went to the ER.  My medical student and I met him there as he shook in bed.  A snarl of IV lines snaked under the covers.

Jimmy gave one-word answers to my questions, and did not open his eyes…
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Educating for Resilience and Humanism in an Uncertain Time

By Darrell G. Kirch

We face a crisis of well-being in medicine. From the acceleration of science to the implementation of the Affordable Care Act, rapid change has become the “new normal” for our profession.  While many of the changes have the potential to revolutionize health care, they also create stress and uncertainty within our community about our personal futures and the future of academic medicine.  At its worst, this stress contributes to the high levels of burnout, depression, and even suicide we are seeing in health care professionals.  As a psychiatrist who has treated physician colleagues, I have seen depression interrupt promising careers in medicine and science.  As dean of two medical schools, I saw the impact of burnout along the entire continuum, from students to senior clinicians…
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