I do not like giving up on patients. I'm finding I have a very hard time talking to families about giving up on their loved ones. This week I had to talk to a family and counsel them that their mom was not going to make it. I wrote the order after they decided to stop aggressive treatments to pull out her breathing tube, and stood by while it was removed.

Only 45 minutes later, she was gone. A nice woman who, although she was sick when she came in, was only 58 and walking and talking and living a fairly normal life. And then she was gone, ushered out of this world and into the next.

It is still very strange for me to be standing looking at a patient who is alive one morning, only to be standing by that same bed a few hours later, performing an exam to pronounce her dead. You cannot hide from mortality in a hospital. Daily I am confronted with the realization that it only takes a few short minutes for life to slip away.

I think a lot about something C.S. Lewis said in his book Mere Christianity, something to the effect of how the strangeness and horror that we still feel when we see death is proof that death is something that is not supposed to happen. If this was how it was supposed to be all along, he argues, then we should be more accepting of it, or we should have been able to evolve the anti-sorrow gene. Something deep inside us, though, whispers to us that all is NOT right here.

More and more I realize that this would be even more difficult and confusing if I didn't know that there is hope in the midst of death. And I praise the one who was born, and lived, and died, but conquered the finality that death was supposed to be.


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