DEATH!

Death, it happens. It happens everyday in emergency rooms all over the world. The tragedy is not the death itself, even if it was unexpected. The tragedy is having to inform someone their father, their spouse, or, the absolute worst, their child has just passed away. The loudest scream I ever heard was about four weeks into my internship. I was walking down the hall when I heard a deafening shrill fill the ED, and I knew instantly someone had just been given the news.

I thought to myself that whenever my times comes to give the news I would do it with such compassion and support that no one would feel the need to scream. I mean, I did take a two week course in medical school called death and dying. I felt adequately trained on the proper technique and the words to use. The problem was when the time came, I wasn't ready. It was 2:45 in the morning and I was on call on the trauma service. We had been pummeled all night, and even at that time in the morning things were still going strong. I was walking alongside a patient being wheeled to the CT scanner when I heard the trauma page ring out again overhead.

"Shit!"

I left the patient to return to the trauma bay. "Three car MVC, two trauma reds are five minutes out," I heard. At this point in the night I was numb to the whole thing. I was already staring at the clock counting down the hours until I could leave, go home, and fall asleep next to my wife. The two traumas arrived, and after just one look I knew they would be headed to the ICU. The problem was in the entire ICU we had only one bed remaining. 2 critical ill patients + 1 ICU bed = not a good situation.

Fortunately (depending on how you look at it), we received a call from the ICU saying one the patients that arrived earlier in the night had just expired. The attending looked at me and said, "Go tell that family of the patient in room 312 the situation. Do it quick so they can get the room ready for one of these guys.".

"The situation," I mumbled under my tongue. The situation was I have to go tell a family I don't know that their family member, a person I never met because he belonged to the other intern that was off handling other business, has just died. I got up to the room just in time to see the house staff putting the infamous white sheet over the body.

"Where's the family?" I asked the nurse.

"I'll send for them."

I looked in the patient's chart to see what caused his injuries. It turns out he was assaulted during a robbery at his residence and suffered massive head injuries. I didn't feel like reading any more, too depressing. The family approached, already shaken up from the events of the night. I looked at them, complete strangers, introduced myself and said, "in spite of the entire medical staff's efforts tonight, Mr. Johnson did not survive the injuries he sus... "

Screams.

I wasn't even able to finish the sentence. Other family members starting asking questions to which I did not know the answers, but as the only physician around I felt obligated to provide them with the most nebulous responses possible. It was terrible and at the end of the shift I think I felt just as bad as that family.

Now I'm not sure there is a good way to inform a family member about the death of a loved one. I haven't had to the give "the news" to anyone else since that time. I'm beginning to think there is no right way to inform someone about a death, and that it might just be easier to get used to the screams.