Fixed and Dilated

I've never seen someone who was dead, let alone stood next to or even touched.

This is almost the end of my fifth month of internship, I'm rotating in ER. We get a call that a patient in cardiac arrest is coming in by ambulance. We prep; gowns, masks, gloves donned, and stand waiting.

A gentleman is brought in on a stretcher, one of the paramedics is stood on the edge of the stretcher performing CPR while the others push. He's transferred onto the ER bed, and a nurse takes over. He's hooked onto a cardiac monitor, I here the word "asystole." I review the steps of CPR we were taught, with my eyes shifting to and fro between the monitor and the patient's chest. I hear the word "pulsless," and "fixed dilated pupils," then hear "CPR for 70 minutes," and I know logically that that's the end of it. I still keep my eyes on the monitor. There's a wave, but I know it's pulsless activity, but don't want to believe it. "That's it guys, announced time of death 22:20." I feel nothing.

The remaining half hour of the shift is the longest 30 minutes of my life. We ungown, the senior writes some notes, and we go back to the station. I stand while the rest of the doctors continue chatting and discussing normally, as if nothing has happened. I watch as they cover him up and take him away. I still feel nothing, but begin zoning out. My senior asks me to take a look at a new patient that had come in with chest pain, to ask him what was troubling him and to examine him. I've never been more robotic, I do what I'm told, but can't think. I've never left the ER that fast, I just couldn't stand being there anymore. How could everything just go on normally after what had just happened?

He wasn't from here. (Can I actually say "was"? Shouldn't it be "is"? I don't know! "Was" just doesn't feel right) I'm not sure he has family here. It's just, he passed away so far from home. I hope he does have family here, I'm not sure why, but I do.

I've never in my life seen someone dead. Standing there didn't feel real. I've always thought I'd be afraid in the presence of death, but I wasn't, I just felt numb. I had helped examine him, I checked his pupils; fixed and dilated, I now know what that means. I'm not sure I'm particularly thrilled about this new piece of info I've gained. I didn't flinch once, what's wrong with me? I voluntarily took the torch, opened his eyes with my own hand, and took a look. Shouldn't I have at least been afraid? Hesitant?

I'm really not sure what I'm meant to be doing or feeling right now. I know this is part of the career I signed up for. I know it'll be a lot worse if a patient dies in front of me, or even worse, on my watch. But for now, I just don't know.

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