The Will To Live Is A Powerful Thing…

… as is the will to die.

Once upon a time, years ago, I watched a man I knew die in his hospital bed, with his family by his side. He was a doctor I had known through the first years of my career, a kindly old country doc with a lifetime of caring for patients already behind him when I was first learning the art and craft of pre-hospital care.

In my early days as an EMT, I didn’t respect his knowledge much. It was clear to me, a young paramedic who knew everything, that medicine had passed him by years before he decided to quit practicing. He was old, and out of touch, and he was a danger to every patient he touched.

Or so I thought.

It took me a few years to realize that the old doctor knew more about the art of medicine than most of us will ever know, even as the science of medicine had passed him by. What he may not have known about the latest advances in trauma care, or cardiology, or infectious diseases, he more than made up for in his love of people… and that love was returned by uncounted patients over his fifty-year career.

He was a healer, in ways that board certification exams and CME seminars can never hope to quantify.

I took him to the hospital on the trip that would become his last, and during the trip he vacillated from suprising lucidity, quizzing me about his condition, to unconsciousness so deep that I feared he had died several times.

And in the hospital, his condition spiraled ever downwards, but he had his lucid moments until the end. Crusty old ER nurses I had known for years, nurses whom I’d have sworn had long since lost all capacity for love or empathy, filtered in and out of his room, each of them leaving in tears after saying their goodbyes.

In the final two days, his family kept a vigil at his bedside. And in his last hour, I had happened to drop off a patient in the ER, and I wandered onto the ward afterward to pay my respects. He lay there is his bed, impossibly frail and still, but his eyes still held life. He’d smile weakly at his wife and children, and then he’d drift off, his features growing slack and the cardiac monitor beeping ever more slowly, until the asystole alarm screeched for ten seconds, fifteen, twenty seconds…

… and then his heart would start beating again, and he’d take a ragged breath, and his eyes would open, and focus, and he’d turn his head towards his family and smile again.

And he did that, again and again, until his son, tears streaming from his eyes, bent down and whispered, “It’s okay, Pop. You can go now. We’ll all be okay.”

I had to leave the room then, because back then I still harbored the notion that nobody should ever see a paramedic’s tears. But I know how it ended, because as I walked down the hall and out the hospital’s rear doors, the asystole alarm continued screeching until a nurse quietly walked to his room, checked his pulse, and quietly walked back to the nurse’s station and turned off the telemetry monitor.

She joined me outside a moment later, let out a sigh and lit a cigarette. By unspoken accord, we didn’t look at each other’s faces in the dim light.

And it was clear to me then, as it is to me now, that Doc died at the moment he chose.

My friend Medic Matthew tells a similar story of a patient who also died when he chose.

Bring Kleenex.