I haven’t cried for a patient in more than five years. I worry I’ve become a cold-hearted bitch who makes small children scream, jabs old ladies with needles, and remains unfazed in the face of relentless suffering.
Sometimes I have to fight off the urge to laugh as some sort of perverse knee-jerk reaction to misery because I don’t have time to cry for every dead patient. I can have up to 250 under my care. By some typical twist of fate, it would be in the two minutes it took me to dry my tears on my bloody scrubs that another one would arrest, doubling my death toll.
I remember my first death. It was a crotchety old man who looked like Mr. Magoo with bad pneumonia. His eyes had already glazed over and he had gone that unusual shade of morgue grey that signposts the end. I took his daughter to one side for my first “death chat,” carefully recalling my six-step training for delivering bad news. It went well and she appreciated the time I took to talk to her. I left for the night leaving her by his bedside waiting for him to pass.
When I came in the following morning he was up in bed, shaking his little old fist, shouting, “Balls!” From close-to-death he had been reborn as a geriatric terror. I went to check on him and he asked, “Am I all right?” I reassured him, that he appeared to be doing much better. Then began his tirade, “Balls! I’m not fucking all right! Do I look all right? I’ve been here for days without food. It’s a disgrace!” Still shocked by his miraculous resurrection, I agreed to give him some dinner. Within hours he let out one last, “Balls to it all!” before conking. I felt cheated. Like he had pretended to get better to taunt us with cruel hope before dying, most likely from his own sour mood…and possibly our sour food.
Much like dumping boyfriends, you get increasingly callous and efficient every time you deliver the death chat to a patient or relative. You become savvy about the small signs that indicate if they will be an arm-flaying screamer, a quiet controlled crier, a raging hater who hurls abuse and blames you for not trying hard enough, or just a shell-shocked jaw-gaper who can’t even register what you are trying to tell them. That doesn’t even begin to cover the spectrum of reactions from trite to gut wrenching. One woman, after I told her that she only had three months to live, asked, “What transport do they provide to the hospital?”
Mr. Magoo initiated me into the various stages of dying. The first indicator generally is when a patient announces, “Doctor, I think I’m dying.” It’s sometimes hard to tell which ones are just being melodramatic and which ones mean it. The next warning sign is a swift and remarkable recovery. Terminal patients have a tendency to get better the day before death. Finally, people turn gray and their eyes glaze over. Then it’s game over. The switch from Beryl, the nice little old lady on ward three, to Beryl, the corpse, is rapid. After death, whatever made that corpse Beryl has vacated her body.
Finally, last words are a myth. No one has ever said anything profound or witty in their choking gasps. Most often they tell my they need to pee, which I now treat with great suspicion in the near dead. Though I’ve always thought Mr. Magoo had a point when he wailed, “Balls to it all!” for the last time.
DR. MONA MOORE
I want Dr. Moore. Take me under your caring wings and I will also scream, "Balls to it all," when my times come.
Posted by: Ule Ule | 18/05/2009 at 17:11
oh no... I have to pee right now. Am i dying?
Posted by: gretchen | 18/05/2009 at 17:14
Diseases don't kill people - hospital food does.
Posted by: Canister | 18/05/2009 at 17:20
so if they need to pee or poo and then they die before doing so, do they let loose after they pass?
Posted by: bacon bits | 18/05/2009 at 17:25
I can just imagine the man's family asking if he said anything before he died.. but do you lie? tell the truth? I don't know, but if my grandfather died and the doctor told me the last thing he said involved the word balls, i'd laugh hysterically. i guess at least until the laughs were replaced by crying.
Posted by: Anonymous | 18/05/2009 at 17:41
You lie if it's not funny.
Posted by: Backnurse | 18/05/2009 at 19:27
yikes. the" arm-flaying screamer" types must be hard to deal with
Posted by: trudy | 18/05/2009 at 20:48
i think i'm a bit late to this column, having only read the last few. it is so refreshing to hear an honest, "behind the white coat" voice from the medical community. these peices are brutal, hilarious, and sometimes heart-wrenching. please keep 'em coming!
Posted by: Georgia | 19/05/2009 at 00:39
can we start a new column where you tell us good ways to avoid getting std's that don't involving not having unprotected sex?
thanks in advance,
charles
Posted by: charlie sheen | 19/05/2009 at 01:08
I think this lady is doing some of the best stuff you've ever published in this magazine, and ive been readin it for 840,000 years.
(i keep saying this about this column, im not actually anonymous but what kind of a narcissiststsciiststc signs their name to a fcking comment board post?)
well done anyway, again.
(write a book)
Posted by: boij | 19/05/2009 at 03:12
are there hipster doctors? do they trade in their scrub for american apparel hoodies after work?
Posted by: anonymous | 19/05/2009 at 16:22
Sorry to see the "balls" guy go.
Posted by: Stitch Up | 19/05/2009 at 16:28
Dr. Moore is amazing. She should have her own monthly column in the magazine.
Posted by: Bradford | 19/05/2009 at 17:42
http://lagazettedumauvaisgout.blogspot.com/ = THE NEWSPAPER OF BAD TASTE
Posted by: Dora | 19/05/2009 at 23:07