Time of Death

Most people I imagine do not think about the concept of "time of death". While working in the emergency department you have to have this "time" in the back of your mind at all times. Immediate death is what we are trying to prevent in the emergency department which is a different approach than many other fields of medicine.

This week I have had the sorrow of having to declare the time of death on 2 patients. The patients keep coming and you must keep working. Often you do not even have time to reflect on the whole process of declaring someone dead until well after your shift while lying in bed or while driving home and then a flood of emotions enter your mind. You work like crazy to save a patient who is dying and you when that effort fails, you declare the time of death. This is just a technicality that society requires doctors to do. It is not like the patient actually died at the exact time the doctor declared the time the death. Often we do not know when exactly or technically the patient has died.

This week I had an older individual that had a heart attack right in front of all of his family visiting for Thanksgiving. We could not save him. He most likely died well before his arrival to the emergency department even though he arrived to us with a weak pulse it is hard to say that he was actually still living. We gave it every effort. My other patient was a young patient involved in a motor vehicle accident and that was a tough case. It was especially difficulty telling the family that they just lost their child. Again we tried everything to save the patient but finally I had to declare the time of death.

All in a days work...... I guess.