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Thursday, May 22, 2008

What's it like to die?

When you work in a hospital you see death more than the average person. It's almost impossible not to think about it. And even though you've seen it, you still have no idea what it is like to die.

Yet, still, I have been asked on more than one occasion the one question no RT, RN or Dr. ever wants to be asked: "What is it like to die."

The patient who asks this is usually one who knows he is dying, yet still feels so alive. If you've worked in a hospital long enough, you know exactly what I'm talking about. One time I had a young patient with terminal cancer, and he'd sleep most of the day only to wake up and say, "Oh, I'm still alive."

That would be a sad way to go.

Once I had a middle-aged lady with end state Pulmonary Fibrosis and her lungs simply had no compliance, or had become too stiff to oxygenate her body. She would smile through choppy sentences and ask, "What's it like to die?"

Perhaps you know already," I would think. Yet I'd say, "I don't know. I wish I could answer that."

So, what is it like to die? I have no idea. But most of the time I imagine that people lose consciousness before they die. Usually your organs start to fail, your kidney shuts down, and you simply lose mental awareness. Then you die.

But what about if you have the big one while awake. Would you not feel agony a moment before you lost consciousness, just before you died?

What about the terminally ill, or those in chronic pain, or those who have no lungs left. There are ways to make the transfer easy, and it often involves comfort measures only and some morphine.

After I finished my round of midnight treatments I sat in the patient waiting room and watched Red Eye on Fox News. I really didn't plan on watching this show, it just happened to be on when I clicked on the old boob tube.

I have no idea the name of the host nor the guest, but the conversation essentially revolved around the death penalty.

The host asked what the worse way to die was. The guest said probably stoning. It was very common in the old world, and is now only common in some far out countries. He said the electric chair has been banned in many states because it's so gory.

The shooting squad might result in instant death if the shooter hits the heart with the first shot. But I simply couldn't imagine the anxiety. I'd probably die of a heart attack before I made it that far.

Perhaps the worst way to die was the Pilgrim way. They used to place people they didn't like in water. If they sunk to the bottom they were innocent, if they came to the top they were guilty and they chopped off their heads.

Nobody accuses anyone else of being witches anymore, but I suppose it's possible that we could execute innocent people from time to time. However DNA testing makes this more and more unlikely.

Now the most common method of execution is by lethal injection. But the saying goes that this may not even be a humane way to go.

Penethol is used to put the person to sleep. Actually, the dose given here is enough to be lethal in itself. Pavulon is then used to paralyze the person so the executors don't have to watch the person squirm. Also, since the person is paralyzed, he won't breath. Then, to top it off, potassium is used to stop the heart.

So how do we really know the person went peacefully or not? Seems convincing to me, but how do we really know?

Is there a humane way to kill someone? How about if we hang them. When we used to hang people, according to the guest on Red Eye, they would have a bowel movement,urinate and ejaculate all at the same time because the muscles all relax. But that happens in all people who die, he said.

Anyway, just something to look forward to.

Still, what is it like to die? Does any living person really know? Well, we watch people die. We can say, "Usually people die peacefully in their sleep." But do they really die peacefully?

A conversation on Red Eye went something like this:

"What's the best way to die?" the host asked.

"In your sleep," the guest said.

"So if someone is sleeping, you don't know if they really felt pain before they went out."


"I mean, it's not like a person ever woke up after dying saying 'It sucked."

Whenever someone in my family has died, this question was always asked by someone: "How did he go. Did he suffer?"

"Nope," someone will say, "He went peacefully in his sleep."

Oh yeah. How do you know?

But when you are the RT or RN or Dr. and you have to talk with the family, and make your humble effort to ease their pain and suffering, you will find yourself saying those same words:

"He died peacefully in his sleep."

1 comment:

Djanvk said...

Good Article,

I often imagine after a code when someone dies that there might just be the spirit of the person hovering over their body for a bit. Gives me a weird feeling.