Medicine Sub-I, Day 8: Comfort

The team was on long call. I picked up a couple more patients. It's been 14 months since I've started on the clinical portion of the medical school curriculum, and I still haven't seen death. Not that I want to, but it's kind of an important part of our education. Not only knowing what happens to the human body as it goes into decline, but also in dealing with the families and helping them to cope with loss.

So, a patient was transferred to our service once it was determined that there was nothing else to be done for her. The letters 'CMO' are next to her name, standing for Comfort Measures Only. And here I sit looking at every resource available, and nobody in my books or on the web wants to talk about how we die. I need to know this stuff because inevitably the family is going to ask the rough questions. Every groan, twitch, gurgle or grimace could possibly be interpreted as a sign of discomfort. I need to be armed with the knowledge that we're doing everything to make sure that she feels no pain, that she's in no distress, that she is at peace.

Anyway, my research-fu is failing me right now. Search strings for 'death', 'comfort measures only', 'physiology of death', 'events in death' have pretty much been fruitless. Perhaps it's because I didn't get out of the hospital until about 2am today, but I think more it's because discussing death is still quite the taboo in medicine. Pretty sad considering we all hit the same endpoint, don't ya think?