Words can't do justice to the intimacy of meeting someone after death
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Version 0 of 1. One among them was dead. Bay 4, bed 4. It’s another night shift as a junior doctor in a teaching hospital covering care of the elderly wards. The name on the white board would be wiped off soon enough. Related: Patients should be able to expect compassion from clinicians It was not an unexpected departure judging by the tired tone of the voice on the phone: “And there’s another one on ward 207 needs confirming as well, bay 4 …” There was no preceding drama with the right substances going in at the appropriate rates it would seem, softening her final ride to some well deserved private oblivion. The hush of calm on the ward as I arrived augured well. There was just a solitary squeak of a nurse in plimsoles, rounding a corner to the sluice room to slop the still undead’s effluent into murkier streams of our water cycle. First on the right, the curtains drawn around the bedspace – X marking the spot. The bay’s other inhabitants were quiet. Soft reverberations betrayed their own fragility and likely turn to come: they had dodged the coffin this time, perhaps not the next. Mixed blessings – for most, varying degrees of delirium or dementia might soften the realisation, with the coming of a wan breakfast and accompanying light, of a fellow traveller’s demise. Confirming the dead is the privilege of the newly initiated doctor. It’s a curious ritual, we quickly learn, for a dead person is quite clearly, well, dead. At night, it’s invariably the first time we’ve met the patient and exhaustion colours the poignancy. Unlike other clinical examinations where the therapeutics of reassurance are shared – something for both parties – the failed search for life can only comfort those left behind. We’re left to it usually shortly after, but sometimes before, a nurse or healthcare assistant has made them more presentable. A crooked mouth or twisted limb smoothed into a more palatable parabola; eyes closed one last time; tears, drool or froth wiped clear. The aesthetics of death attempt to conjure away a weathered grimace. I approached the sticky, sickly nylon curtains lightly, keen to not wake any of the patients, most of all the one I’m here to meet for the first and last time. I gently pulled aside enough of it to squeeze around the edge. My footfall softly trespassed the dead’s allotted spot of lino flooring, I am halted in my tracks by a strange sound – a high-pitched belching noise. A kind of casual ructus, as if in the company of old friends (or nobody), the bitter delights of a hearty meal revived. Or was this a final note of departure, from the depths of the small bowel? To make some noise and push aside a weary confusion, I clicked on the pen torch, noisily and business-like. The healthcare assistant startled at my presence before regaining her composure. I glimpsed a face, ashen grey in the bedside lighting, but also animated, briefly, by a flash of colour and movement. A flicker of remorse, or apology? Something more as well: an air of accomplishment, of closure, a curiosity finally quenched. As if she’d finally found the courage to answer a question she’d barely acknowledged a shameful craving to ask. She vanished out of the cubicle, with disturbing speed for her bulky and arthritic frame. She left behind a trace of tobacco and cheap deodorant lingering in cool lifeless air. Already cold, the flesh gives up its poorly kept secret quickly. All it takes is a slow second to take in the absolute stillness. There is an awkwardness in death and the final discomforts of living are crystallised. Life’s constant negotiations between muscle tone and gravity end in this final grim truce. The skin has a waxy dryness to it. The pupils are lifeless orbits. Overlying them, a disinterested opacity already banishing a clarity that until recently had stuck it out. The crepitations of my fingers’ articulations masqueraded the absolute silence in the caverns below. The stethoscope’s diaphragm made its ritual short journey, for form’s sake. She was dead. And already she resembled the fresher cadavers of the dissection room, that rite of initiation for medical students where we first meet death. Fatigue flavoured a few moments’ thoughts to the life she’d led and those she’d left behind. As I made my way out of the cubicle, I noticed something on the bedside cabinet. It was a large, luridly pink toy – a rubber pig – and squeezable. I recollected the sheepish look of satisfaction on the assistant’s face. It was also capable of producing – for the bored and curious – the pathetic cry I’d just come to hear. It was a sad mascot for the deathbed. Outside, I made an entry in the notes. A few lines of clinical findings document the obvious – death confirmed – with a time, date and signature. Later, during daylight, myself or another doctor will make the official certification, listing the causes, or in uncertainty or other special circumstances, refer to the coroner. Another life. Another death. Another statistic. Related: Humanity lies at the heart of an NHS worth keeping Becoming blunted to a range of emotions is a byproduct of the job. The extraordinary can fast become routine. And yet for me, words can never do justice to the strange, sad and sometimes oddly banal intimacy of meeting someone for the first time, shortly after they’ve passed away. If you would like to write a blogpost for Views from the NHS frontline, read our guidelines and get in touch by emailing healthcare@theguardian.com. |