Lesebefehl: What we learn from the dying

Ein Arzt schreibt über seine Erfahrungen mit todkranken Menschen. Achtung, Halskloßgarantie...

The problem is, death keeps looking at us. When I'm forced to think about this, what I see most clearly are the faces of patients at the moment they recognized the incredible fact that they were going to die soon. This is what I can't forget: the look they had as they read the writing on the wall like Belshazzar did at his feast in the Bible story, faced at the height of his power with the message that he was about to die. Just what people see as they read that message is, I suspect, the most important fact about death. I know that fact escapes my grasp, but I keep reaching for it, all the same.

He was 18 years old with cystic fibrosis. By unspoken agreement, we had left him until last on morning rounds, because overnight the lab had analyzed his blood and cultured Burkholderia cepacia — an organism that flourishes in the pus that overwhelms the lungs in end-stage cystic fibrosis. It's notoriously resistant to antibiotics. (It's been found growing on penicillin.) Once B. cepacia escapes the lungs and enters the bloodstream, death is inevitable: sepsis, circulatory collapse, multiorgan system failure, the end.

After a muttered conversation in the hallway, we edged into the room. I was nervous: I was going to have to tell this kid he was dying. He was awake, sitting up in bed. The room was dark. It had that lived-in look CFers cultivate — posters, clothes strewn everywhere, a game console flickering on idle. A wasted-looking father slumped in the corner chair. The patient watched us file in. When I saw the expression on his face, my anxiety about what I was going to say seemed suddenly unimportant.

He knew. He already knew.