Death: The High Cost of Living

I am an avid fan of Neil Gaiman and in his best work to date, Sandman, Death is the sister of Dream. She is protrayed as a perky goth girl.... how nice.

In reality, death is lurking around us all the time. Especially for those of us in the medical profession. Perharps so much so that sometimes we forget the tragic side of death and become numb to it.

There was a time when I was still young and nothing in life seemed impossible. I believed that we should spare no cost in saving every life. It was only after becoming a doctor that I realised my believe was just magical thinking of an immature child.

My first professional encounter with Death was with a lady in her fifties. She suffered diabetes and consequently her heart was failing. Her husband had admitted her for a severe infection of her right leg. The only way to save her life was to cut off the leg but there was no chance of her surviving such an operation given her heart condition.

I had seen her briefly during the morning round and she was pretty alert despite the high fever. As I made my way around the wards in the afternoon, I noticed her chatting with other patients, smiling to the nurses. I was paged in the night and the nurse in charge told me she had stopped breathing.

When I arrived at the scene, the MO was already there. I was panting from the 100 metre dash looking all flustered and unsure. The MO gave me a reassuring smile and told me that nothing needed to be done. Just to certify that the patient is dead.....

Pupils fixed and dilated
No heart beat
No breathing
No response to pain
No reflexes

This is Death. She is not a perky goth girl. She was cold and distant.