Last week, I was summoned to a patient room in ICU shortly before a patient was expected to die. She was a woman in her 70s, and when I arrived, several family members had gathered to be with her. I was there in the last few minutes of her life, and with her family well afterwards.
It was the first time that I had watched someone die.
Death is a strange thing. What was unexpected is that life is not an on/off switch. There was no precise moment of her death. It's not like in the movies where the heart just stops and there is a loud, continuous buzzing from the heart monitor. Even the heart does not just simply stop; residual electrical activity continues until it fades away almost imperceptibly.
Her death was more vague, more fuzzy and obscure. There was a time in which she was alive, and a time in which she was dead, and a softly-defined boundary in between. The systems of her body simply shut down, one by one. She did not die at one point in time, but rather faded from life.
It was something that I had not at all expected.
About a minute later, a fixed boundary was demanded from me. Another relative came into the room. It the midst of the confusion and chaos of the crowded room, it was uncertain what was happening. She looked at me and said, "What's going on?" The nurse said nothing. I had to make a split-second decision that (1) yes, the patient was indeed dead in every clinical sense and (2) to inform the woman of her grandmother's death.
For a while, the timing of death was vague and uncertain. Life did not turn itself off in the patient; it faded away like a receding tide. But then it was official, stated, and formal. The boundary between life and death had ceased to be fuzzy, and was not sharp.