Tuesday, October 24, 2006

The Dreaded Inevitable: First Patient Death

This week's Grand Rounds is great, as usual. I don't have the time to read all the posts I want to, as usual. For some reason, though, long after I should have been in bed, I went through some of the posts.

I quickly realized that this GR holds two posts on the same topic: two separate med students,
Ali Tabatabaey and Jenn, tell of the first time a patient of theirs has died.

It was hard to not feel my eyes getting wet as I read those, one after another. I've heard and read so many accounts of physicians, on blogs and in medical journals and textbooks, about how they simply do not forget their first patient death.

I won't forget the first time I learned about this. I read it on Incidental Finding's
blog the summer before I started med school. He wrote, "The first patient of mine that died, in my 3rd year of medical school, I can recreate her history and physical exam from memory. If I sat down for 10 minutes, I could probably come up with her medication list as well." He titled that post, "One is too much."

It's something that will happen to me, inevitably. And it will stay with me until the day I die. As vital a part of my education it will be, I can't help but feel that I want to put it off as long as possible.


I'm adding to this post after I initially wrote it, just to note that there are already emotionally heart-wrenching things I've experienced in medicine that will be with me forever.

I won't forget the sight I saw when I walked into an OR
while I was in Nigeria to find a stilborn infant, fully formed but seemingly asleep, laying abandoned in a kidney pan as the surgeons closed up his mother.

And, when I was shadowing an ER doc, I experienced a truck driver dealing with the devestating realization that - even though it was an accident -
he had ended human life.

Tonight, after writing this post, I tried to fall asleep, but couldn't, because in my head, I could still hear that man crying.


Jon said...

simon, this is a great post. It has an honest and respectful tone about it, as you realize some of the hardest things about what you will face in your future. I know you are strong, and I know you will handle these challenges as well as any one of us could. When in doubt, just act like Dr. Cox on scrubs. Find some intern, call him girls names all the time and demean him until you feel like a bigger man. Godspeed.

incidental findings said...

I have to commend you for realizing that death is a vital part to your education. After all, there's a reason why M&M conferences exist: we often learn the most from the worst outcomes.