The Secret of Death
I'm too young for this. That's what everyone says-or at
least thinks, the way their eyes track across my features, down to the name on
my coat, then back to my face. It's OK. I tell myself that I can earn the
respect automatically granted to someone with a few gray hairs. Besides,
there's a difference between age and maturity and these days I don't feel
It's not that I'm jaded. Far from it. I still care about
every patient that rolls into my unit and every family member that shuffles out
of its doors. But I watched a man die on Thanksgiving Day. I wrapped my arm around
his wife's shoulders-a woman my mother's age-while I switched off his life
support and bid farewell to my innocent youth.
Don't feel bad. I know what I write can be a depressing but
that's not what I want. Most days I don't even leave work sad. Because every
time I see someone die I get a little closer to learning the secret of life.
I've already told you that, in the ICU, the scoreboard
is rarely in our favor. I've shifted my goals away from "saving lives,"
though my mom still thinks that's my job. If it was, I wouldn't be very
satisfied. People will die. I've decided to worry less about the existential
question of "why" and focus on what I can control, the "how."
I think everyone has some idea in their head about how they
would like to die. They might say "in my sleep;" that's always a popular
answer. The lack of awareness brings comfort. Most people would choose
"painless" and in modern medicine that's easy enough (though the application is
often botched). But these answers are reflexive, generated by fear and aimed at
avoiding the physically unpleasant.
The next response will be some variation of "surrounded by
those I love." Children and grandchildren are often mentioned as well as the companionship
of a long-wed spouse. Ah, now they are
starting to get it. These answers aren't offered impulsively for a sense of
protection. They come to mind because they represent something else: a sense of
accomplishment in life, a completion of purpose.
In a fantasy death, most people are 80 or 90 or even 100
years old. And from what I've seen, the older someone is, the more accepting
they are of death. I don't think that the age itself is a comfort or that the
number on your birth certificate matters. But even the most deliberate person
figures 80 or 90 years is enough time to accomplish the things that matter.
But what about the others? What about the globetrotting
businessman in his 60s or the 54-year-old mother of two college students or the
32-year-old who hasn't sent her first daughter off to kindergarten? Surely
their greatest deathbed fears revolved around unfinished business. The same
reason I had a lump in my throat when they passed.
Now you remember that this wasn't supposed to be a
depressing blog and I promised some bigger lesson. Here it is: death will
happen and there is no telling when. You can't be angry about death just like
you can't be angry about gravity. There is no debate. So don't ask what we will
do about death. The real question is: what will we do about life?
The daily brush with mortality has had a strange effect on
me. It didn't make me sad or scared or even pessimistic. If anything, it
produced the opposite effect. I've started to take a few more risks, have a
little more fun. I spend a little more money and eat a little more dessert. I
skip the gym on occasion for the opportunity to try something new. And if
something scares me, I do it.
If you believe age matters, maybe I really am too young for
all of this death. But I'm not afraid of it. I've seen it enough; we are old
friends. The only thing I am truly afraid of is not having lived.