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A patient of mine died today.
He was a 98 years old male, who I've known for many years, even before I was a doctor.
He was a sweet guy; anyone would have wanted him for grandfather. Playful, always happy, full of jokes and histories to tell.
I hospitalized him 8 weeks ago because of a pneumonia. Got in and out of the hospital for the last two months. Even at that, he joked about, saying "bah, I'm an old fart and I'm supposed to die soon, why do you worry so much? Death can't be that bad!"
I hospitalized him yesterday. He came into the ER joined by his daughter and his granddaughter, who used to be my girlfriend for a long time and is a good friend of mine. He wasn't in great shape; came in cyanotic (with bluish lips and hands), breathing heavily, burning in fever (40°C). After a full physical examination, I diagnosed him with a pneumonia. We moved him into the imagenology department and took a chest X-ray which confirmed the diagnosis: It was a rather large pneumonia, going through the half of the right lung to it's lower portion.
That, plus his age, plus his latter history of respiratory diseases, was not good.
I was brutally honest with the family. I did not see him well and it was a bad pneumonia. We'd do all our best but I wasn't sure it was going to be enough.
My patient told me, gasping: "Do what you have to do, child. If I go, don't be sad. It's my time anyway and I'm not afraid..." And then turned to his family: "And neither should you. Don't be afraid..."
I hospitalized him and his family wanted to stay with him. So they did. I prescribed oxygen, antibiotics and some acethaminophen for his fever.
He went progressively worse. I was checking up on him all night. I mean, I knew him for as long as I can remember. He almost became family (I was with his granddaughter for over 5 years). I WAS worried. Not only as a doctor, but as someone who knew him and cared for him.
No matter what I did, he kept getting worse.
I spoke to the family. He was going to die. I was making sure he was comfortable and not in pain.
3 hours later he lapsed into a coma.
4 hours later, he died, peacefully, with a smile on his face. Me, holding his hand along with his daughter.
Then, his granddaughter said something to me that has been ringing in my head ever since:
"Honey, thank you for letting my pops go well. Thank you for letting him die well."
And I can't write anymore because I'm getting all emotional and I don't know why.
Thank you for reading.
 
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Annnnd then proceded to plow the granddaughter
User was banned for this post.
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On July 26 2012 06:13 CygNusX-1 wrote:
Annnnd then proceded to plow the granddaughter
What the hell is wrong with you? Totally not the place or time for that.
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On July 26 2012 06:13 CygNusX-1 wrote:
Annnnd then proceded to plow the granddaughter
I can understand your lack of impulse for sex, but not the lack of impulse (and rationalized thought, thereafter) before posting something so... lacking in taste.
Thanks for the 1 star rating anyways... I guess.
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"bah, I'm an old fart and I'm supposed to die soon, why do you worry so much? Death can't be that bad!"
I love this perspective. Death is difficult for the living, not for those that have passed on. It's important I think to realize this.
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I think you've done the family and yourself a great service. Having someone die in peace and in happiness is a great gift that you have given this man (and the family too). You know, judging by your blog, that you've done everything in your ability to help this man.
I guess there is a time for everybody, however it can be rough on the people left behind. My condolences and thanks for sharing.
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On July 26 2012 06:04 UmbraaeternuS wrote:
And I can't write anymore because I'm getting all emotional and I don't know why.
I don't understand this part, surely it's incredibly obvious why you're feeling emotional?
Decent blog but this part ruined it a bit for me.
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My patient told me, gasping: "Do what you have to do, child. If I go, don't be sad. It's my time anyway and I'm not afraid..." And then turned to his family: "And neither should you. Don't be afraid..."
Losing someone you care about is tough, but this man wouldn't want you to be upset. Your friendship and love is something he would have smiled on, contributing to the full life he was able to have. Miss him, but celebrate his full life, and your friendship.
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On July 26 2012 06:31 Ryka wrote:Show nested quote +On July 26 2012 06:04 UmbraaeternuS wrote:
And I can't write anymore because I'm getting all emotional and I don't know why. I don't understand this part, surely it's incredibly obvious why you're feeling emotional? Decent blog but this part ruined it a bit for me.
I don't know myself. Maybe it was the 'knowing him' experience? Maybe it was what his granddaughter said? Maybe it was the whole losing a patient thing? Maybe it was the approach of dying he had? Maybe it was the whole thing?
I don't know, man. It isn't obvious for me, a dude who has been trained to understand this shit. Maybe I'm not supposed to understand it, I'm just supposed to feel it and that's it.
But I don't want to leave that part out of the story. I'm not ashamed of my emotions. I don't want to look like I "manned up" and took it like nothing. I don't want to tell just a part of the tale. I want to share the whole of it. Emotions included. Even though for some people it might sound corny and cheap, because that's how I feel about it and emotions, especially at times like this, are important.
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Sad.. Makes you realize the important things in life. Really brave of him!
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You're emotional for a lot of reasons. Working in the medical field isn't going to make it any easier from what I'm told. My family members who work as nurses at least tell me that they can handle death more often easier than they expected they could, but that makes the hard losses even worse.
Regardless, I'm sorry for your loss, but jealous you knew a guy so seemingly awesome. RIP, old dude.
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On July 26 2012 06:20 UmbraaeternuS wrote:Show nested quote +On July 26 2012 06:13 CygNusX-1 wrote:
Annnnd then proceded to plow the granddaughter I can understand your lack of impulse for sex, but not the lack of impulse (and rationalized thought, thereafter) before posting something so... lacking in taste. Thanks for the 1 star rating anyways... I guess.
Don't take what he said to heart, he only has 1 post count, it's a troll account that's soon to be banned.
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China6327 Posts
RIP old pal.
It must be hard for you man.
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On July 26 2012 07:13 NoctemSC wrote:Show nested quote +On July 26 2012 06:20 UmbraaeternuS wrote:On July 26 2012 06:13 CygNusX-1 wrote:
Annnnd then proceded to plow the granddaughter I can understand your lack of impulse for sex, but not the lack of impulse (and rationalized thought, thereafter) before posting something so... lacking in taste. Thanks for the 1 star rating anyways... I guess. Don't take what he said to heart, he only has 1 post count, it's a troll account that's soon to be banned.
it's awkward that the account was created 2 years ago. maybe several members have like 10 back up troll accounts over the years that they take out and make some troll posts with then are fine with them being banned, seeing as they have a dozen more they can use to pot anytime.
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Good blog, reminds me of my grandfather's death ;_;
Thinking about these things makes me a bit sad but maybe it's a good thing to keep them in mind once in a while. And get over the smaller problems in a way.
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Brave old man... must be hard to be in a position of a doctor like that.
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I can't really imagine how it would be like... I don't really know what to say, really.
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On July 26 2012 06:31 Ryka wrote:Show nested quote +On July 26 2012 06:04 UmbraaeternuS wrote:
And I can't write anymore because I'm getting all emotional and I don't know why. I don't understand this part, surely it's incredibly obvious why you're feeling emotional? Decent blog but this part ruined it a bit for me.
yes because he's writing this for the sake of your enjoyment. Show a little respect, he's just being honest with how he's feeling.
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98 years is a good run. Im glad to know he was well cared for and died with friends and family. Thank you for the blog.
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It's a good thing he got to see you a doctor who would care and feel for him. Thanks for sharing this story.
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great blog, i enjoyed reading it. From what i've heard, as people get older they are less afraid of death because they've experienced almost everything they can or wanted to anyways, therefore they die with satisfaction.  The grandpa was probably already tired of what earth has to offer him.
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great blog, proud to know we have doctor's like you
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"Thank you for letting him die well."
I'd like to live my life that I can say that I can die well.
Nice blog.
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He lived a long life, and you helped him make it a better one. Take pride in what you did, and know that he left peacefully.
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Is the "don't know why" part on being emotional because of the fact you are a doctor and and there's that thing about not getting emotionally attached to patients? (speaking from a layman's pov). I'm assuming he's not the first patient you've lost...just the closest.
Sorry for the loss. Good read.
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Like the guy said, you shouldn't feel bad or sad or anything.
He had to die sometime, and 98 is a really good run. He was happy, he was very well prepared, and so was everyone who loved him.
That's a very, very good way to die. For everyone involved.
Some people die suddenly, unprepared, horribly, and it devastates everyone. That's when you feel sad.
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He went peacefully and thats the best anybody can ask for. Good blog.
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I can only hope I go out like he did, surrounded by loving family and friends and knowing you've had a good run on this earth, and with the positive attitude he had.
R.I.P. homie!
On July 26 2012 12:48 BoX wrote:
Like the guy said, you shouldn't feel bad or sad or anything.
He had to die sometime, and 98 is a really good run. He was happy, he was very well prepared, and so was everyone who loved him.
That's a very, very good way to die. For everyone involved.
Some people die suddenly, unprepared, horribly, and it devastates everyone. That's when you feel sad.
It's perfectly normal and healthy to grieve at this time. It's his right to do so - don't take that away from him, please.
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Then, her granddaughter said something to me that has been ringing in my head ever since:
Say what. Shemale? o.O
+ Show Spoiler +Honestly though, I totally understand you. Losing some of the best lives can be the hardest losses.
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98 years? I can only wish to have a chance of living that long.
I wonder though at 98 years do you get bored of life? Does having loved ones you used to know / grow up with / look up to die before you make you dislike life? (obviously not so much in his case because he had his daughter and granddaughter)
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My condolences.
A fine example of a human being, giving his last gift.
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He went in peace, that really matters. You should not feel bad, like many people here have said. But hey, it's not like you chose to feel that way.
It reminded me of a story my father told me recently, of a great uncle of mine who passed away many years ago. He used to read to his wife every evening. One night, he was reading, and then came to a pause. When she looked, he had passed away, just like that. A very old man, doing what he loved to do, sitting and reading a book to his wife.
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98 years old is quite amazing and his readiness to move on from this life is also a wonder. I think of all the illness and tragedy that will take most of us before that age... to make it through to 98 is a miracle. And his state of mind... how many people are ready for death when they die?
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my condolences
the guy must have had a great life, leaving this world like that
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I'd just like to thank you for writing this, it was a good read.
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His death was a peaceful one. And it seems he lived a life to which he really could bring closure.
Glad that when he finally passed, you were with him.
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When I'm lying on my deathbed, I want to have that state of mind. No regrets, no fear, just acceptance of what is inevitable, and happiness for the life I lived.
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What a noble man and a graceful way of accepting closure. May he RIP.
Thanks for a good read.
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On July 26 2012 06:36 UmbraaeternuS wrote:Show nested quote +On July 26 2012 06:31 Ryka wrote:On July 26 2012 06:04 UmbraaeternuS wrote:
And I can't write anymore because I'm getting all emotional and I don't know why. I don't understand this part, surely it's incredibly obvious why you're feeling emotional? Decent blog but this part ruined it a bit for me. I don't know myself. Maybe it was the 'knowing him' experience? Maybe it was what his granddaughter said? Maybe it was the whole losing a patient thing? Maybe it was the approach of dying he had? Maybe it was the whole thing? I don't know, man. It isn't obvious for me, a dude who has been trained to understand this shit. Maybe I'm not supposed to understand it, I'm just supposed to feel it and that's it. But I don't want to leave that part out of the story. I'm not ashamed of my emotions. I don't want to look like I "manned up" and took it like nothing. I don't want to tell just a part of the tale. I want to share the whole of it. Emotions included. Even though for some people it might sound corny and cheap, because that's how I feel about it and emotions, especially at times like this, are important.
Now that's a real man who you are
Respect.
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Nice blog sir, can only hope my passing to the other side is as graceful as this. I have always wondered the toll all of this stuff takes on the doctors.
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Doctors get crushed physically while in school trying to practice for all those tests and exams then when they graduate from school get crushed emotionally having to see people they know they tried to help but couldn't save die right in front of them O_O. Lots of respect for what you do but I think he wouldn't want you to dwell on the his death, just take it to heart and move on. (wrong wording but its hard to get across what I mean >.<)
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The acceptance of death is hard process , 98 years is a lot of years of life, i would like to speak some to people like that, so much wisdom.
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It sounds like you did the old man a solid, what more could any of us ask than to be well cared for at 98 and surrounded by friends/family?
No worries brother, I sincerely believe you'll see him again some day, whether here on Earth or in another place.
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On July 26 2012 06:22 caradoc wrote:
"bah, I'm an old fart and I'm supposed to die soon, why do you worry so much? Death can't be that bad!"
I love this perspective. Death is difficult for the living, not for those that have passed on. It's important I think to realize this.
o really? Have you died and came back to tell us how easy it is?
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Like its out of the movies. Thank you for becoming a doctor. The world needs more people like you.
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thinking about becoming a doctor myself, does this stuff get any easier to deal with?~
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I really, really enjoy your blog. Thought provoking and emotionally powerful. Thank you for sharing
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I'm coming to appreciate your blogs more and more. They're all really poignant. Thank you for sharing this
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On July 27 2012 04:56 wei2coolman wrote:
thinking about becoming a doctor myself, does this stuff get any easier to deal with?~
Not trying to diminish this but there are far worse things you will probably have to deal with if you become a doctor :/ Guy passing away at 98 with a smile on his lips and his family watching over him is about as good as death will ever become. The way i understand it his sadness come more from losing a friend than a patient, and you are probably going to have to deal with it regardless of you becoming a doctor or not
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If there was a ladder for doctors, you would be a Grand Master.
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On July 26 2012 06:13 CygNusX-1 wrote:
Annnnd then proceded to plow the granddaughter
User was banned for this post.
I almost feel like a terrible person for it, but I lol'd.
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thedeadhaji
39489 Posts
"Do what you have to do, child. If I go, don't be sad. It's my time anyway and I'm not afraid..."
This brought tears to my eyes.
You have great storytelling style, UmbraaeternuS.
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thedeadhaji
39489 Posts
On July 26 2012 06:36 UmbraaeternuS wrote:Show nested quote +On July 26 2012 06:31 Ryka wrote:On July 26 2012 06:04 UmbraaeternuS wrote:
And I can't write anymore because I'm getting all emotional and I don't know why. I don't understand this part, surely it's incredibly obvious why you're feeling emotional? Decent blog but this part ruined it a bit for me. I don't know myself. Maybe it was the 'knowing him' experience? Maybe it was what his granddaughter said? Maybe it was the whole losing a patient thing? Maybe it was the approach of dying he had? Maybe it was the whole thing? I don't know, man. It isn't obvious for me, a dude who has been trained to understand this shit. Maybe I'm not supposed to understand it, I'm just supposed to feel it and that's it. But I don't want to leave that part out of the story. I'm not ashamed of my emotions. I don't want to look like I "manned up" and took it like nothing. I don't want to tell just a part of the tale. I want to share the whole of it. Emotions included. Even though for some people it might sound corny and cheap, because that's how I feel about it and emotions, especially at times like this, are important.
"I don't know, man. It isn't obvious for me, a dude who has been trained to understand this shit."
I take it it's not your first death as a doctor right? That's probably why it's a "I don't know why".
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On July 27 2012 11:24 thedeadhaji wrote:
I take it it's not your first death as a doctor right? That's probably why it's a "I don't know why".
You are right.
I never thought of it that way...
Thank you for sheding a little light on this.
I want to be as strong and wise as him when I'm on my deathbed. He truly was a great man.
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thedeadhaji
39489 Posts
On July 27 2012 11:26 UmbraaeternuS wrote:Show nested quote +On July 27 2012 11:24 thedeadhaji wrote:
I take it it's not your first death as a doctor right? That's probably why it's a "I don't know why". You are right. I never thought of it that way... Thank you for sheding a little light on this. I want to be as strong and wise as him when I'm on my deathbed. He truly was a great man.
Also, you didn't just lose a patient -- you lost a friend, and in many ways, you lost family.
edit: 
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That active at such an old age is impressive and admireable... A family friend recently took his own life(at age 60~ish) because he was diagnosed with ALS and knew he wouldn't be able to care for himself. I wonder if I would be strong enough to do the same if I thought I would be a burden to my loved ones; or if perhaps his method was the cowards way out.
^Hope that didn't seem disrespectful =/.
~ Thanks for sharing interesting concept to think about.
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Moving story. What were his secrets to such longevity, perhaps you can share?
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Man losing someone dear to you is an emotional experience, my condolences. He had a good life, and he will be remembered.
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losing a loved one, regardless of how long he or she had lived, is tough. RIP.
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I think we should never be sad about a death caused by old age (or an illness or disease, which indirectly is caused by age). Of course there's always a family/friends/close ones who lose someone dear, but grief in such a situation feels selfish.
You were able to make his last moments comfortable for him, no pain, no suffering, a koma, poooff gone without him noticing it, with people around him who care about him and who he cares about. Dying in your sleep with your loved ones around you so to speak, I am sure there are legions of humans out there who would happily wish for such a death.
Amidst all that (understandable) grief, the feeling of joy should be as present though, joy for the old man who seemed to have been very happy and satisfied at the one point in time we fear all our lives. So many are not given that opportunity.
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Good job. You did right by him, and I'm glad to hear that you're a caring doctor. I know some who'd sonner put everyone over 70 on morphine and let them die peacefully but it's usually that they don't want to bother to help them when there's also younger patients to take care of. It was his time anyways; he knew it.
It's also nice to hear of a man who was pleased with his life, and accepted that all men must die eventually. He gave his family the brave words they needed to hear, and was also blessed with a sharp mind until the very end. His family is very lucky in that.
Valar morghulis.
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"This too shall pass." It's what makes life beautiful
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Ah, shouldn't have read this My dad died age 59 three weeks ago from pancreatic cancer, probably the most unpleasant thing I will ever go through (I hope). Now my mom is having a mental/emotional breakdown. Thanks TL for linking some good distractions to keep my mind occupied during the down time.
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Whenever I see that you have posted a blog, it really makes my day better. The reflections on life really cause me to, after reading them, see the world in a different way. Thank you, and I'm sorry for your loss.
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On July 27 2012 09:02 WikidSik wrote:
If there was a ladder for doctors, you would be a Grand Master.
Thank you for the compliment, kind sir, but I'm not yet worthy. I still have a very long way to go. I've been practicing for only two years.
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intrigue
Washington, D.C9933 Posts
what a lucky dude. hope mine can be as happy :D
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so how much did you bill his ass for all of that end of life care?
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On July 26 2012 06:31 Ryka wrote:Show nested quote +On July 26 2012 06:04 UmbraaeternuS wrote:
And I can't write anymore because I'm getting all emotional and I don't know why. I don't understand this part, surely it's incredibly obvious why you're feeling emotional? Decent blog but this part ruined it a bit for me.
agreed, there's absolutely nothing wrong with you getting emotional. A dear friend, near family member, of yours passed away, at least it's good you were there to help him through it and gave him a good, pain-less death.
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What was your first experience with death like, as a doctor?
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On July 28 2012 22:48 ParkwayDrive wrote:
so how much did you bill his ass for all of that end of life care?
Nothing. Our health system ensures gratuity for the state benefitiaries.
And no, it hasn't been my 1st patient death.
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That was a touching story. The emotion you managed to transmit through your writing tells me that you're going in the right direction. It's nice to know that even doctors who face death regularly can't phase out these sorts of feelings; it's what defines us as human beings.
For what it's worth, I suggest you take the granddaughter's words to heart as you continue your work. So many old people die alone; I'm glad your friend had you and his family by his side to his last moments. Others aren't so lucky.
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On July 28 2012 22:48 ParkwayDrive wrote:
so how much did you bill his ass for all of that end of life care?
You must be from the US. This care is free in the public healthcare system in my country
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His positive attitude towards passing away is very inspiring. I hope to one day also leave life as gracefully as him, without any apparent regrets, smiling.
Thank you for posting this and I'm sorry for your loss.
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this is exactly why i could never be a hospital doctor. i get emotionally attached (too strong a word but you know what i mean) with people quite quickly and i take stuff personally, expect too much from myself etc. It would be too much to watch people/people you've known forever dying and not being able to do that much.
that being said, i respect you and all doctors who do what you do. great blog, i can imagine it might be quite hard on you... just remember you did what you could and the man went out the way he wanted.
rip, 5/5
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You should be happy for him. So few can die so happy. He must have lived a very fulfilling life.
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I wonder, how can you conclude a five year relationship not marrying?
o_o ???
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Such a good blesssing to live to be that old and to die peacefully
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Can you explain why you prescribed him such "normal" medication? Was it because of how poor the prognosis was?
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On July 31 2012 22:49 TheSwamp wrote:
Can you explain why you prescribed him such "normal" medication? Was it because of how poor the prognosis was?
There's this thing called "evidence-based medicine" which guides a physician's proper practice.
You guys in the USA have created this ruling (or standard-setting, if you prefer the term) agency called the ATS, or American Thoracic Society.
The ATS set a protocol and classification for pneumonias, and also specified the suggested treatment for them regarding their causal agent and type. Hence, an ATS III-class pneumonia is treated by a very specific set of medications regarding the kind of causal agent your patient has or might have. Should I use Augmentin, or Clarithromycin, or Levofloxacine, or Ceftriaxone, or which antibiotic? That question is answererd by that specific protocol, which would be very, very boring for you guys to read, since it's extremely technical and full of medical jargon.
So it isn't about the will to use a medication or another only per the doc's order. It's about abiding by the set rules and treating a patient as you know you should: As the standards tell you to.
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May he rest in peace
Thank you for sharing such a deep and beautiful blog
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EPT
