志闲少欲,心安不惧 泛中医论坛

Death, the beginning of life - Remembering the first time announcing a patient's death

On that afternoon, I bid farewell to the first patient of my medical career.#

The patient had multiple metastases of rectal cancer, and the condition had been deteriorating. Two days ago, during a department discussion, everyone unanimously agreed that the patient's time was running out. We contacted the patient's family and asked them to come and see him while he still had some consciousness left. This was the first patient I had been involved in managing since my internship, so I attached great importance to him. I watched as he went from being friendly and amiable when he was admitted to becoming weak and frail. As an intern, there was nothing much I could do, so I could only do what little I could, such as escorting one family member after another into the ward to inquire about the patient.

The first person to come was his daughter, asking if her father was in pain and if he had any cravings. "I'm fine, don't worry about me, just do whatever you need to do." Next was his younger brother, who told us about the hardships his older brother had endured over the years. As the eldest son, he had endured humiliation and shouldered the heavy responsibility of supporting the whole family. He had also ignored rectal bleeding for a long time due to work, until the cancer was diagnosed. Then came his sister-in-law, who was asked why there were so many people in the ward today. Wasn't the hospital supposed to control the number of visitors? His sister-in-law gave a poor excuse, saying that today was an open day and everyone had time to come and visit him. Finally, there was his nephew, whom he had watched grow up, and they made a promise to celebrate together after he was discharged.

As time went on, the patient's mental condition worsened. He gradually started to doze off and even fell into a deep sleep. Whenever the patient couldn't respond, I could only exchange glances with the family members. They would open their mouths as if wanting to say something, but in the end, not a single word would come out, and they would let out a long sigh.

That afternoon at three o'clock, I was in the doctor's office flipping through books, trying to catch up on knowledge related to cancer. Suddenly, there was a commotion outside the door. A nurse came in and reported that the patient's blood oxygen level had dropped to 90. What should we do? The response from the superiors was brief: give up resuscitation and start filling out the death certificate and notifying the family. As the one in charge, I quickly followed the nurse out. The other classmates from the department followed behind, helping the nurse clean up the equipment. We formed a circle in front of the patient's window and watched him leave.

We watched as his breathing became agonal, deep and large, then gradually weakened and finally stopped. Only the sound of gurgling came from his throat, with bubbles forming and bursting, like a fish out of water. We watched as his hands waved in the air, his feet kicking back and forth, and then slowly becoming sluggish, with only occasional twitches of his fingers. We watched the monitor as his blood oxygen level dropped from 90 to 80, 70, until zero.

I thought that death was a quick process, but we waited for a long time, and everyone's faces became solemn. I asked the senior students, "Have you ever had an experience like this before?" One of them patted me on the back and said, "Everyone goes through this process." Finally, I unskilfully took a limb lead electrocardiogram, and each lead showed a flat line without any fluctuations. I wrote down the time, attached it to the medical record, and this was the last thing I could do for him.

Back in the office, I felt empty and idle. I walked out again and stood in front of the ward door, watching the family members with red eyes as they cleaned his body and dressed him in funeral clothes. I couldn't bear to watch, so I retreated back to the office and sat there blankly. Knock, knock, the door opened, and it was his daughter choking back tears. She said, "My father didn't suffer much in his final days. Thank you all for your efforts."

After that, I don't remember how I finished my shift. All I remember is the heavy feeling in my chest as I rode my bicycle slowly back to the dormitory from the hospital. Liang Bo's song "I Don't Know" played in my mind.

<audio src="" name="I Don't Know 2020 Theme Song from the TV series "Extraordinary Pediatrician"" artist="Liang Bo" cover="" loop>

That star shines together with the moon,
Dispelling loneliness and solitude.
It shines on every second of darkness, illuminating you.
The injured child no longer cries,
The weary no longer run.
Seeing you smile happily, as if
You don't know anything at all.

That afternoon, the wind was strong, and tears fell, making my eyes feel cold.

After studying medicine, as my experience increased, I gradually gained a clearer understanding of the fragility of life and the pain it endures.

Last winter, my father injured his finger while working and went to the orthopedic hospital for company. There, I saw all kinds of patients. There was a farmer whose hand was severed by a grass-cutting machine, and after the surgery, it swelled up like a bun, turning purple and black. There was an elderly lady who broke her foot while hoeing, and she spent the whole day chatting with her son about family matters. There was a child who had a bone fracture from a fall, and every morning during the intravenous drip, he would cry and fuss, but in the afternoon, he would play with his phone as if nothing had happened. Compared to them, my father's case was relatively mild, but even so, the dressing changes every three days would make this man, who never complained of fatigue or pain, close his eyes and furrow his brow.

Before this, life was a common commodity flooding the streets. Afterward, with the experiences I had in the ward rotations, life gradually became precious. It is not visible in normal times, only in the darkness of the film, can its whiteness be contrasted against the blackness. This profound black is the phlegm tinged with red, the trembling hands, the indistinct syllables, the deformed joints, and the twisted abdomen.

This contrast between black and white is frightening and regretful, but it also teaches us to cherish life.

Death is the beginning of life#

One day, the group leader of a study group brought up a topic:

"Without experiencing severe illness and death, one cannot truly understand the reality of life and death. What do you all think of this statement?"

In the past, I had seen similar questions and didn't think much of them. But now, with my own experiences, I firmly believe it. I believe that having experienced life and death, my medical career is just beginning. From this day on, I truly realize that what I have learned will be put to practical use, saving lives. If I am not solid in my knowledge, not proficient in my practice, and fail to perform when faced with real problems, it will no longer be just losing a point or two on an exam paper, but the patient's chance of survival.

Death is the beginning of life. Life and death are like yin and yang, opposing and transforming each other. Only by witnessing both life and death can we truly understand the value of life and make more efforts for it.

First published on "Concordia Eight"

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