Let’s get weird.

Do you remember the first time you saw a dead person? I was 6 years old, and had traveled to North Carolina for the funeral of my great-grandmother. I don’t remember the lecture my parents surely gave me in preparation. All I remember was walking into that dimly lit room and seeing her in a soft pink suit laying in a casket. She had pearls and glasses on; her dyed red hair perfectly quaffed. I remember my father leaning down to kiss her forehead. I looked at her hands and thought they looked hard. I think my dad encouraged me to touch her, but I didn’t feel right doing so. I just stood there for a moment, staring intently at her chest, waiting to catch her taking a breath and surprise us all with a morbid prank. I wasn’t afraid, but I felt uneasy. Since then, I always feel weird looking upon the deceased at their “wake.”

Thinking back to the first time I saw an “expired” patient…side note, isn’t that a weird term? Expired? What are they, bad food? Like, “ew, get the expired THING out of here.” Once you die, you stop being a human and turn into a “corpse” or simply, “the body.” I was a nursing student at a VA hospital, working 7pm-7am, and was anxious to be invited to escort the recently deceased to the dun dun dun…MORGUE! It really was on the lowest level of the hospital. (We don’t have many true basements in this part of the country). Me, my nurse-preceptor, and a hospital security person marched the decedent, covered by a white (not black) body bag on a gurney, to the elevator in the middle of the night; not having to worry about diverting the gaze of nosey passerby’s. When the elevator doors opened, it really did look like a scene from a scary movie. Flickering fluorescent lighting, a long, a poorly maintained hallway, brown and green hues that looked like this place was forgotten in time. What an interesting transition from the part of hospitals where guests are allowed. We turned a corner and the security officer used a special key to unlock the huge, metal door. You may have seen these as “walk-in” coolers in resturants! There was a simple binder with pages of patient identifier stickers and handwritten facts about times surrounding the death—what time they died, what time they got to the morgue. There weren’t any other bodies in this walk-in, but there were several items on shelves wrapped in white, labeled with patient barcodes. I examined the largest item, which turned out to be an amputated leg. I joked, “why are they saving this, for soup?” The nurse teaching me chuckled at my morbid curiosity, and took me into a seemingly secret room, through another door at the back of the walk-in. This was the medical examination/pathology workroom. It was also green, if memory serves, with black and white checkered floor tiles and a single porcelain table. She said autopsies were sometimes performed here. She also explained that the leg was probably still in the morgue for a) pathology studies, and b) because the patient/family had not made a decision on what to do with it! I suppose it would eventually be incinerated; unless the family was anticipating the rest of the patient’s remains would soon be “expiring” too. In which case, the amputated limb would accompany “the body” to the funeral home at the time of death. Weird, right?

Finally, I recall the first time I helped with a “code blue.” The ER was abuzz with radio chatter of the EMTs calling in this case and their ETA. 38 y/o black male, suffered a cardiac event while driving. When the patient arrived, it was organized chaos. I stood in a corner and admired the way the interdisciplinary team went to work. I was asked to “jump in” and help with compressions. I stood on a stool, hovering over this large man in my white student scrubs. I remember a resounding command: “push harder!” The pressure seemed like it would break the man, despite his size. His eyes were open and bulging…I noticed something was off about them…it is hard to explain, but there was no “light” behind them. I tired extremely quickly and jumped out of rotation. We couldn’t get IV access, so the physician whipped out a tool kit and slammed in an IO, intraosseous catheter, into the patient’s right shin. It’s not optimal, but it’s better than no access. I don’t remember how much time elapsed; it felt like both a blink and an eternity. In reality, it was probably 20-40 minutes of efforts. Finally, the doctor “called it,” and declared a time of death. Just as quickly as the room had flooded with helpers, it was empty in just a few moments. I stayed and stared…why couldn’t we save him? That’s it? For the first time in all my clinical experiences, I felt like I was going to faint. My nurse-preceptor was kind and compassionate, and took me to a private room to reflect. I’ll never forget the look in the man’s eyes as I towered above him, terrified for his fate, already knowing it was decided.