Death

I have worked as a Registered Nurse for many years. I have witnessed many deaths. No two deaths are ever alike. No one is ever ready to die.

I recently wrote an article on self motivation. This article can be read at here . The article prompted Mr. Rana Sinha from dot-connect.com to say, “I wonder Shergill if you’d be interested in writing about how terminal patients are prepared for dying? I’ve read much of the work of Dr. Elizabeth Kubler-Ross on the topic. I’ve some friends in the health-care industry and dying is a real taboo topic. Then there are controversies by Dr. Kevorkian and others, but the taboo still remains”. Mr. Sinha made the request on June 6, 2008.

The article, which is referenced above also contained this picture. I have cut and pasted it here. I wonder, if this picture prompted Rana to seek my views on death?

Picture: Patient on Iron lungs too can find ways to boost his critical focus.

Here is my very personal response. It is based on professional, personal and family circumstances.

No one can ever be “prepared” to die. Medications like morphine, prednisolone and anti-depressants make the patient feel that they will not die. I call it an “artificial high”. Even patients who know that they are going to die will, most of the time deny it. After sometime, when reality sets in, they will go through a depressive phase followed by negotiations and finally acceptance. No two patients are the same, ever. Patients who are too ill may be unconscious and are not aware of impending death.

Patients who had been very ill and had almost died i.e. successfully resuscitated, tell different versions of what they saw in the “beyond life on earth.” Quite a few patients who “came back” say that there were angles etc waiting for them. I guess it is the influence of “Christianity”. I did not keep a tab about the religious beliefs of those patients. Since I worked mainly in western countries it will be reasonable to believe that it reflected the patient’s religious beliefs. However, this may not be the whole picture. These visual images, which the patients (who came back from the dead) described, could be due to electrolyte imbalances of the brain and body. They could also be due to pain relieving medications, neuromuscular blocking agents and/or anaesthetic gases.

In my lifetime there was a time when I wanted to commit suicide. I seriously contemplated it very secretly. However, my illness was so bad that I was not able to get rid of myself. My disability prevented from killing myself. The paradox here is that when I got better I did not want to die. I believe I am still alive. Funny, I only wanted to die when I could not do anything for myself. This takes me to another topic, conveniently!

I have looked after many young patients with spinal cord injuries. When these young patients who are severely injured are brought into hospital they usually want to be allowed to die. They are usually in shock and feel that life is not worth living i.e. they do not want to live as “disabled individuals”. However, after about four weeks of hospitalization and active treatment they usually want the hospital staff to do everything to save their lives. A remarkable turnaround by any stretch of imagination! All I can say is that initially the patient relates with his “fit and active life”. He is probably trying to live with what we all say casually, “I’ll never want to live like that for the rest of my life”. As time goes by the patient probably realises that it is better to be alive than to die.

I was accidently electrocuted. I initially fought the current but was then at peace with myself. I was relaxed and was ready to die. I thought I had died. Shocked! to find myself alive. I am still alive. I picked myself up and went away from the exposed wire, where I was shocked. Came back to look at it from a distance! I was really frightened to go near it, just in case.

Many patients call the nurses, me included, at night to tell that they have this feeling that they are going to die. We sit and listen. We try to read between the lines. Usually, these patients do not die. They are usually “lonely,” in strange and frightening environments. A reassuring talk and a cup of tea are usually sufficient. Guess who dies most often? The patient who is too ill to call for help and had appeared to be asleep when last seen! The next day the patients who called for “feeling lonely” will tell the real story.

Many patients “come to terms” with death. They will seek reassurance that they do not suffer from excessive pain. However, some patients take the bitterness along with them. I was looking after a patient who was “with it” when he was informed that he will die because we could not do anything for him. His family came to see him to say “good-bye”. He turned his face away and did not want to see his family members. I felt really sorry for the family members and the patient. I wish I could do more but the time and circumstances were horrible. I saw all the emotional hurt, pain and drama. I cried inside, “inside my heart”. This was one of the saddest moments in my life time. I have seen a lot in my lifetime. In all my previous experiences, “families came together during crises”. This one was very unusual. Sadly, this patient was conscious and “with it” until the very end. I guess he conveyed the “ultimate message!” I do not know what it was.

I support an individual’s right to die. I support Dr. Jack Kevorkian. However, I do not believe that anybody who is really healthy wants to die. We are human beings. We are impulsive creatures. We often make statements like, “kill me, I want to die” etc. I believe, if a person seriously wants to die he should be allowed to die. Such “planned deaths” should be legal. Since nothing is simple, here is the twist. There should be a cooling off period of about four weeks and the patient should have the right to cancel his death until the very end. Nobody should be allowed to die at the spur of a moment. The “cooling off period” will allow the patient and family to seek treatments / remedies to the problems. All patients should be offered all the treatments that are available for their disorder(s).

All the cases in which Dr. Jack Kevorkian helped were truly legitimate requests to die. I do not see anything wrong with that. I know that the RC Church is opposed to “assisted suicides”. The RC Church should put it’s dollars where it mouth is. If hospitals were to save all patients aggressively all intensive care units will fill up within a day. There will not be sufficient beds, ventilators, $s, ministers, stock or staff. The RC church needs to get real.

I am also opposed to the death penalty irrespective of the nature of the crime (s). A family member was sentenced to death when he had not committed the crime. Finally, this family member was freed but it (the experience) has traumatised our family for at least two generations. States should not play god. They are not infallible.

Registered Nurses are required to be able to care for the dead and the dying. If you wish learn about caring for the dying and the dead you are advised to read this.