I haven’t seen very many people die.  Instead it’s people who’ve already died and then are brought to the ER (usually still dead), or people who are about to die that we prop up long enough to die in the ICU, or people that die just a minute before I get to them in response to their code blue.  Of those that actually manage to die in the ER, most are lined and tubed and monitored so that their death is observed not on their person but rather in an aseptic collection of downward trending numbers oblivious to our resuscitative efforts.

But then I saw a 103 year old man who actually looked fine but turned out to be in complete heart block.  And then some time later his heart rate jumped from 40 to 190 and now he was in V-tach.  He still looked fine so I just stood somewhat mesmerized by his sine wave waiting for the nurse to come back with the amiodarone.

And then abruptly his sine wave became a flat line.  He had a Do Not Resuscitate order in the chart so I didn’t.  Instead I just watched him.  For a few long seconds his countenance seemed to defy his condition.  But then his eyes rolled back in his head, and his color began to change from pale to red to dusky blue.  His mouth kind of drew in on itself in a manner wholly unnatural with life.  I asked his son if he wanted to say goodbye and he did so I led him to the bedside and everyone else including myself out of his room.

But I continued to eavesdrop from the remote heart monitoring station.  And I saw a blip in his flat line, then another, and soon his heart was beating again, more normal than when he arrived.  I headed back to his room to find him eerily well appearing, as if the last few minutes had abruptly been erased.

Like I said, I haven’t seen very many people die.