Time of Death

The first death on your watch isn’t even your fault. You’re just one of the many interns who rush to the bedside when the code is called, peering at the doctors crowding around. As the patient gasps and chokes, you too gasp and choke as each electric shock blasts through the body. The doctors are grim-faced but determined; you hopelessly wonder why they even bother. Again and again the voltage is cranked up, but thunderbolts can only do so much.

The doctor holding the paddles slowly turns away from the flaccid flesh and another quietly asks, “Time of death?” You back away, feeling as if the defibrillator was really meant for you as your heart pounds out its own furious pace. A devastated mother takes your wrist. “Time of death?” she whispers, mis­taking you for a doctor, someone who tried his best to resuscitate her darling daughter, someone who knew what he was doing, someone with guts enough to challenge death. Not a first-year intern who never could remember which number was the systolic for blood pressure, not someone who didn’t even dare to take blood sugar levels.

“I’m so sorry for your loss,” you blurt. “You’ll be able to talk to the doctors inside …,” you mumble, patting the trembling hand. She bites her lip and nods, letting go of the scrubs that you shouldn’t be wearing, the scrubs reserved for those who can save lives, not for those who don’t even know how to gently break death to a loved one.

The third death is similar, only this time you’ve been dragged along for scut work. You’re the one ramming your hands into the sternum, trying to force the fluttering heartbeat into your rhythm. You’re the one leaping out of the way of the defib paddles, jumping back to start compressions again. The patient bottoms out, but after the paddles thunder a third time, you can feel the thump of the heart, tangoing with yours as you collapse against a chair, arms quivering with strain. You shudder with relief. You brought him back. You saved him. You.

The eighteen death is the hardest. That little baby in neo-natal care should never have been forced to live on machines. Each breath is a struggle, and the medications are flowing in a poisonous concentration for such a small body, yet the parents insist on continuing the farce of life. They’re unwilling to bear any grief while their baby boy wheezes and thrashes weakly, seeking comfort but receiving only the hard embrace of a hospital cradle and the groan of machines.

The mother shrieks, “He’s blue! Do something!” After you reach the crib and despair at the readouts, you motion the code team away and beckon to the mother and father.

“The best thing for him is to take him off the machines,” you say.

The dad glares. “You want to kill him.”

They don’t understand the torture they have put him through. “If he even survives a year, he will be severely physically and mentally disabled. For life,” I persist.

The mother moans, “He’s blue! I don’t care. Just save him! Now!”

You nod at the code team, maneuvering yourselves around the tiny crib and pulling off the oxygen mask, trying to fit your large palms against the flimsy baby with his face scrunched up in a silent wail. The heart drugs aren’t having any effect due to the amount of medication already flowing through his body.

“Use the shocker!” the mother wails.

“We can’t!” you snarl, trying to give compressions to a weak chest and an even weaker malformed heart. “Your baby is too small and his heart is deformed! If we do, we’ll kill him!”

The code leader shakes his head. “Time of death ….”

“No!”

“3:36 p.m.”

The thirty-third death is the best death. You’re the one in charge. If a code is called, you will wield the paddles, call out “Clear!” You have the final say on time of death if it occurs. You won’t let those words pass your lips.

But she smiles at you through her pure white hair. “I’m ready to leave. Are you ready to let me go?”

You sob, throw down the clipboard. “No, Mom! I don’t want you to.”

She still wears the tender smile of years past as her body wastes away and shrivels to a mere fraction of her vitality. “But it’s necessary. I need you to. And you know it.”

“Mom ….”

And she brushes her hand against yours, squeezing it once before closing her eyes. “You’re ready.”

You kiss her cooling cheek then note: “Time of death: 9:12 a.m., Thursday, April 24 ….”