“The brain acknowledged the approach of death while the heart stubbornly insisted upon immortality” -Dean Koontz
Brain death is such a difficult concept to cope with. Understanding it medically is easy, emotionally is another story.
I am working in the neurosurgical ICU and I had a patient who was declared brain dead. The doctors informed me and I then had to take that patient off my list. I sympathized with the family when I walked passed them in the hallway, but that was it. I had moved on to my other patients. The very next day I was at work and I received a phone call to say a friend of mine was declared brain dead after a rugby accident. I left work immediately and went through to the hospital he was at and very quickly did my sympathy turn to empathy. When speaking to the medical team treating him, I wanted to rationalize everything medically but it was just impossible, I was too overcome with emotions.
Now this blog post could be filled with emotions and how I was feeling at the time, but what is more important to concentrate on is how much of an eye-opener it was for me. We always give bad news to patients and we tell the family that we’re sorry, but I can tell you now, those words don’t mean anything to the ears receiving them. I’m not saying that we shouldn’t console these people; we just need to remember that the words do not sink in, so we cannot blame them for thinking irrationally at the time.
Before this incident I became desensitized to death, as a way of coping with it, because if I found myself too attached to a patient and they happened to pass on, it would really throw me off my work. Over time coping became easier. Now after the situation with my friend I’m finding many triggers at work and I am no longer as rational as I was before. For example when a patient of mine was no longer getting better, the doctors had decided to withdraw treatment and refer the patient for palliative care. This was a difficult situation for me, on one hand I knew to only treat as necessary, but on the other hand I wanted to do everything I could for this patient. However in the end I knew to only do non-invasive treatments and to keep him comfortable.
The problem is that I now have anxiety about patient death, but I do not see this as a bad thing. This new outlook for me gives me a new purpose at work and I do anything and everything for every single patient. Not once do I feel too tired to do treatment. I now have this urge to make sure all those little things are not overlooked anymore, I find myself speaking to the other health professionals even more now. It gives me peace of mind knowing that I could handover my findings from my session to the other disciplines involved.
I’ve been given a wake-up call. Harsh. But much needed.
2 thoughts on “Meaningful Life & Death”
Hi Ayesha,
I would just like to thank you for the level of openness and honesty that you have expressed in this post! I cannot relate one hundred percent with you in terms of dealing with the loss of someone you are close to in this manner, but I too have been in neurosurgical ICU and have struggled with the similar kind of struggles. Often we so easily just say to patients loved ones that we are sorry for their loss, but are these words that we say to them, because it’s the socially acceptable thing to do? Or is it deemed professional behaviour?
In this type of profession, dealing with the death of a patient is something that becomes a norm for most of us, and to a large degree we become desensitised to it. Is this a way that we are able to cope with dealing with the death of a patient? Is it normal to feel this way? I think a patient’s death is traumatic, no matter who the patient is, however their a certain factors that definitely affect the way in which we deal with the death of a patient and this can be anywhere from the duration of time spent with the patient and potentially the relationship you have developed with the family, to your own person spirituality and attitudes regarding death (Gagliardo, 2016).
One thing, that you could maybe look to improve on, is adding more academic evidence to support a claim that you made regarding how you coped with the situation and if that is the typical way in which health professionals tend to cope with the death of a patient. It may also have been helpful to have looked at other coping strategies that people could use, in order to encourage them, in the event of them going through a similar experience.
Withdrawal of care was probably one of the biggest things that I struggled with when working in that ICU. My thoughts on this topic can be read more in my post written on this subject https://iepcourse.wordpress.com/2018/03/26/meaningful-life-and-death-dealing-with-death/
References:
Gagliardo, T. (2016). Effective Coping Mechanisms for Nurses Following Patient Death. Senior Honors Project. Retrieved on 11 October 2018, from https://digitalcommons.uri.edu/cgi/viewcontent.cgi?article=1500&context=srhonorsprog
Dear Ayesha,
I am terribly sorry to hear about the loss of your friend and off your patient. Death is a hard event to overcome without it having to be in your line of study or work. I liked the way how you described your original approach to the death of a patient in comparison to how it is following the death of your friend.
You spoke of your reaction to the family of your patient and how you now believed that when you say you are sorry your words are “meaningless” in a sense. How do you now feel the best way to respond to the death or brain death of a patient to their family is?
I also understand the you say you have had a change to the way you approach a patient you treat, do you worry that your new attitude will begin to return to your old habits once enough time has passed or once you enter a different environment? You are currently in an ICU where the main priority it to maintain life, but do you believe your approach will continue to an area of your field where the goal is no longer to extend life but to ensure the patient is able to live a meaningful life?
I look forward to hearing your response.
Tessa