September 20, 2017 Musings Comments (12) 418

I watched a woman die today.

Twenty-seven years a doctor and I still haven’t become accustomed to it. I’m not even sure when the exact moment is, that instant of death. Is it the last beat of the heart, or the concluding gasp, or is it the terminal  neuron sparking out – the final neurotransmitter molecule crossing the last closing synapse like a desperate man jumping Niagara Falls? What, officially, counts? She was a beautiful old thing – a palace of a woman – her body a castle of stories and history. You could tell by the family, the loving way they held each other round the bedside, that she was a good woman. Had led a worthy life, and her legacy had spread through her progeny with the steady stealth of a slow burning fire.

But still, I found it difficult. I, unlike her beautiful children, had only just met her, a few hours before. She had turned frail with the last season; her lungs had thought about giving up several times in the previous month, and this episode of pneumonia was determined to take her out. At 83, the decision by everybody who hovered over her, to cap care at an agreed upon ceiling, was entirely appropriate. So we all gathered around in a quiet little side room, with not much more than a gentle hiss of oxygen, and some moistening of her lips, to bear witness as she departed.

I watched intently. I don’t often get the chance to do this. Would there be some sign? Something to indicate that a solid, practical, blood circulating life of flesh was changing places with a world inert? Was her life flashing behind those papery thin eyelids with their spidery, barely pulsating veins – an old fashioned silent movie reel? The word spiritual came to mind, but I was no closer to understanding. Whatever time it was, I made note of it in her records. Rest In Peace. And it was peaceful in that room, only a quiet, juddering sob here and there.

The family, all four of the children, hugged me. We’d made all the decisions together; they’d been heard, their mother, and her life – that good one, full of friends and dinners and choir meet ups and laughter – had been respected. The rarity of being thanked, and for letting someone die, stopped my own breath. And then I had to go, because a rhinoceros of a meth-addict was screaming down the corridor just beyond, and something needed to be done.

What a job. What a phenomenal, amazing, heart-breaking, privilege of a thing.

Follow, share & like this:
  • Even writing about such a sad subject, your writing is so beautiful, Michelle– you really captured the dignity of this moment. I’m in awe of you and the poetry you put into describing your world.

    • My first comment! Thank you Emily – this means a great deal coming from you x

  • Mark Thomas

    Besutifully described! One of the best changes during my four decades of medicine is the transformation of death from something whispered and denigrated (“the patient failed to respond”) into a crucial part of continuous care, including aftercare for the family.

    • Thank you Mark, brilliantly put. Yes – these are precious moments.

  • Lisa Laidley

    As usual, beautifully written Michelle

  • Mike Abernethy


    I think it was Cliff Reid who said ” I dignified life is important, but so is a dignified death”

  • Thanks Michelle
    I now have something to share with all my friends and family when they say how hard my job must be with all the death in ICU …I try to explain what an honour it is to witness many of the best aspects of humanity (Love Courage, Loyalty, Selflessness and many more) on a daily basis. We are truly privilidged to experience this wonderful humanity almost daily and thank you for capturing it x

    • Yes – we are the lucky ones x

  • Yahdiel Abihu

    Thankyou Michelle,
    This makes me want to be a doctor so much more. It was heartwarming, enlightening and inspiring, thankyou.

    • Then the whole blog shall be worthwhile 🙂