Print Email

Medical Humanities

Dying for the First Time

Jesse Kane
M.S. III Sackler School of Medicine

He just lay there, stripped naked on the table with monitors beeping around him, being watched by two nurses working, two doctors standing calmly, and three medical students, occasionally asking questions but mostly standing in confused excitement. He was wearing a beautiful gold watch with the clock facing in towards his body. His skin was a ghostly white -- all but his suntanned arms which seemed to hold the only hint of life left in him. 

He had suffered a severe inferior wall myocardial infarction and presented to the Emergency Department with a complete right bundle branch block, which quickly slipped into cardiogenic shock. I don’t know why. I mostly just watched. I saw the doctor draw blood from the femoral vein -- to take biomarkers I assume.  The patient was unconscious. They did not defibrillate him. His pacemaker was useless; the pulses it shot through the cardiac conduction system were unable to excite the dead cardiac musculature into contracting. 

They used a C.P.R. machine at a rate of 100 beats per minute. The force of the machine cracked his ribs, and I saw his chest change shape. His fragility made him so human to me. The experience was so real, and I didn’t want this man to suffer. I felt a restrained sadness well up within me. The machine sent shockwaves down the man’s obese torso. It produced a pulsating beat, and one of the nurses began to dance. I made a few comments to my classmate, discussing specifics of the case to distract myself from the reality I was watching, but it didn’t really work. My mind was racing, trying to understand the medicine, knowing he was going to die. I saw his left leg twitch once in 45 minutes. Nothing else moved. 

The doctor checked his pupils and found no reaction.  The man was going to die if he wasn’t completely dead already. I tried to remember the words on the page in the textbook listing the criteria for death: “no light reflex, no spontaneous breath, flat EEG” and few others I couldn’t remember… my brain came up short. 

The patient would not die.  The pacemaker was set to 60 B.P.M, and the magnet the doctor used had failed to turn it off.  We all stood watching and waiting for the magnet to work, for his pacemaker to stop, for him to go. His body grew whiter; with each passing minute his legs looked more and more like the ones I dissected in the anatomy lab. There was no sound. It wasn’t like in the movies where everyone scrambles around to beeps and shouts followed by the inevitable flat line. I don’t even know when his heart stopped. They performed an echocardiogram just to show the heart was not contracting. The lingering electrical actively was stubbornly fading away. 

Outside the room, I saw his family crying from the news.  I saw his son asking to see his father’s body. I saw his wife, his sisters, daughters, and brothers crying. I was reminded of what it was like for me in the hospital as a teenager when my older brother died. I turned away and held back the tears. The patient was 65. I wondered what kind of man he was. Was he a good father? Was he a good husband? Did he have a good life?

As medical students we are often placed into the most intense and intimate moments in the lives of our patients and their families… often in situations where we feel we can provide little support or care. There is no chapter in Harrison’s on how to watch a human being die. No seminar could address the emotions I felt watching him fade away or the grief of his family members receiving the news. It is only with these experiences, these intimate moments, that we can learn the true value of medicine, beyond the science. 

From that isolated corner of the examination room, feeling the rush of emotions crawl through us, we medical students watch and learn what it is to be a doctor. Torn. Trying our best to understand the objective and technical aspects of medical practice, while allowing ourselves to be flooded with the experience and the emotions rising up within. Striving to understand the humanity of our patients. Looking for balance. From this corner, we can begin to find the best medicine we have to offer -- within ourselves. May I forever be grateful to this man for his lessons, and may God bless him.

Jesse Kane was born in Queens, New York in 1987, to a professor and school teacher. Raised in a very philosophical  and academic environment, he left his home in Long Island in 2005 to pursue studies in Biology and Neuroscience at Oberlin College. After graduating with High Honors in Neuroscience in 2009, he decided to pursue a medical degree in Tel Aviv, Israel at The Sackler School of Medicine. Jesse Kane is currently a 3rd year medical student, and spends additional time a serving as captain of the Israeli Men's National Lacrosse Team. 

Deputy Editor's Comment