Life and loathings of a new doctor: A grave subject
Part of the almost daily
routine of a junior doctor is to certify the death of patients who die on
your ward. For various reasons I have found that the grim reaper tends to
swing his scythe in the medical wards more often when compared to my
experiences in the surgical wards. Legally it's a huge responsibility
to certify a death and therefore it's important not to become too
lackadaisical about it, despite the almost monotony of it. Emotionally it
can be quite tough; my first death was a patient younger than me. I like to
think that my degree in anatomy has hardened me to dealing with the
deceased. It can be disconcerting, however, to certify someone dead when
they are still warm.
In the United Kingdom, a family may choose to bury or
cremate the remains of their deceased relative. If they decide on the
latter method then two doctors have to complete a cremation form stating
that there is nothing suspicious about the death and that there is nothing
left in the patient that is likely to blow up the crematorium - for
example, a cardiac pacemaker.
Again this is an onerous task, which I take seriously.
If the patient dies overnight we have to make the long tour down to the
hospital mortuary to see the body the next morning. Hospital architects
seem to always place the "pathology outpatient department" in
the basement, at the end of a long dark tunnel. They seem to want to keep
the dead far out of sight of the living. Low hung halogen strip lamps dimly
light the path deep into the dull gloom of the hospital bowels. The
electric air here is warm and oppressive regardless of the season outside.
Insulation clad pipes hum and buzz with the mechanical groan of hospital
activity. We do what we have to do then turn and run for the pure fresh air
of our wards, as if lingering too long would risk following the fate of our
departed patients.
Stephen Goldie, medical preregistration house office, Royal Alexandra Hospital, Paisley
Email: stephen_goldie@hotmail.com
studentBMJ 2005;13:221-264 June ISSN 0966-6494