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 ┬áneuron 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.

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About the author

Dr Michelle Johnston is a consultant Emergency Physician who works at an inner city hospital. Mostly her days consist of trauma and mess. Also, she writes.

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