Sunday, February 24, 2019

Memento Mori

OldNFO had a post a couple of days ago about a panel at the Life, the Universe, and Everything Conference on Grieving.

The questions:
Question 1- Professionals working in fields that encounter death frequently tend to compartmentalize everything. How does this impact their reactions to death and grieving?
Question 2- What impact does military service have on reactions to death and injury, and how would that differ from civilians who encounter death frequently?
Question 3- Writers often approach the character who knows that they have a limited lifespan with fatalism or over-caution. Those are reactions that people have, but they’re hardly the only ones. And people don’t usually stay in either one as they actually get a chance to grieve the perceived loss and accept a new reality. What does this actually look like?
Question 4- Burnout is a real problem for police, military, and medical professionals alike. How much of that is related to being unable to grieve deaths that have happened in a professional setting and what does that look like for a character?
Question 5- How does someone with a chronic illness relate with people who are able-bodied and healthy? And how does working closely people who are living with chronic illnesses change your perception of it?
I (obviously) wasn't there, and only found the post after a gnarly night of gunshot wounds and traffic manglement (happily, no one died in our care) but here's my answer:

Unless you buy it after an IED explosion, or going out like Quint in Jaws, death mainly hurts the friends and family.

No one ever woke up during a Code Blue and said "Ow!". They were over it, and generally speaking, long gone and well past caring at that point.

And if they've had their threescore-and-ten, or more, it isn't really necessary to "compartmentalize" their death; someday, it's going to be everybody's time.

The hard ones are the way-too-early ones, especially kids and infants. No one pulls the plug on those for an hour or more, because kids.
And people doing the codes have kids, or have had.

Military deaths vary: for most, it's a growing up process, because it challenges the invincibility of youth. And what pisses you off is the sheer inexplicable randomness of it. Rarely can you say , "Well, Jimmy ate it because he did X stupid thing", because usually, you did the same thing as Jimmy, you were just five steps ahead of him or ten steps to the left, and sh*t happens. But it takes awhile, and some maturity to process that and come to terms with it.

Guys who make a career of flying or being around it see more death in peacetime than anyone else, and being the methodical types, try to glean some nugget out of it to make it not a waste. Some lesson to learn, some sort of "let's not do that again" message from a lost squadron-mate.
But sometimes, someone goes out, and just doesn't come back, and no one ever knows why.

A character in a situation facing their own mortality would go through all five of the Stages Of Grieving, randomly, serially, and every which way. Besides fatalism or over-caution, I have to think there would be some sense of hyper-awareness, of processing every sight and sound and sensation, because there was coming a final moment. They'd live every minute; scarcity brings value, something as true with time left on earth as any other thing.

I don't notice burnout, and I've been doing this 20+ years.
Sleep and days away from it solve a lot of problems.
That doesn't make hard cases and tough beats less, but the end of the day, the person on the gurney isn't me, or friend or kin, so when Death happens, I'm just the gate agent at the boarding ramp for the ECU (Eternal care Unit). You do your job professionally, you treat the subject with dignity before, during, and after, and you do the best job you can. I imagine it's like being a concert maestro who knows he's going to be executed after the last note: you'd want to deliver the most perfect final performance you could, right? It's exactly like athletes saying "leave everything you've got on the field." Even in a game you think you're going to lose, it isn't over until the last whistle.
If I was half-assing it, it'd be harder on me. I know it would. But if someone dies, and they died after I did every possible thing that could be done, there's no shame in not being superhuman, because the enemy (Death) gets a vote.

Chronic illness, and working with it, fills me with sadness when I see people who gave up, or chose stupidly and unwisely, and are finally paying the penalty of one big mistake, or a lifetime of little ones.
And it instills in me a dread that I do keep locked in some deep, dark basement, to hope to never have to face going slowly, by inches, for any reason. Everyone hopes for "the big one" to just check out relatively quickly and painlessly, ideally while asleep. No one says, "Please, let me lose my mind first, and then have my body hang on, so I can be screaming at the walls, rotting from bed sores, crapping in my diaper, drooling untasted pablum, and not recognizing my family until I finally get a massive septic infection and die."
And I can totally respect the person who chooses to go skydiving or mountain climbing, and have an "accident" facing that, choosing to meet Death on their own terms, instead of puttering along until all their own choices are forfeit. Or, not, and deciding to float with the current until The Day.

My 2¢.

Because I could not stop for Death –
He kindly stopped for me – 
The Carriage held but just Ourselves – 
And Immortality.
We slowly drove – He knew no haste
And I had put away
My labor and my leisure too,
For His Civility – 
We passed the School, where Children strove
At Recess – in the Ring – 
We passed the Fields of Gazing Grain – 
We passed the Setting Sun – 
Or rather – He passed us – 
The Dews drew quivering and chill – 
For only Gossamer, my Gown – 
My Tippet – only Tulle – 
We paused before a House that seemed
A Swelling of the Ground – 
The Roof was scarcely visible – 
The Cornice – in the Ground – 
Since then – ‘tis Centuries – and yet
Feels shorter than the Day
I first surmised the Horses’ Heads
Were toward Eternity –                          Emily Dickinson

 I mention this to remind folks that Death is part of life (rarely the fun or welcome part, but a component nonetheless), he follows his own schedule, and, exactly as Terry Pratchett imagined, HE TALKS IN CAPITAL LETTERS.                                             


Bear Claw Chris Lapp said...

Lost Mother, Father,Brother and F-I-L while in close quarters. Would not trade that time for all the wealth in the world. You younguns give your parents a hug and tell them you love them every chance you get because it is the one thing you will miss. The Almighty gave and gives me peace but I still mourn on occasion. My mother never got to meet her grandchildren, or enjoy a childs wedding it is what it is.

Cederq said...

Like you being around death when it comes knocking friends and family members have called me indifferent, unfeeling, uncaring. I didn't fall apart and act the fool. When death is a daily part of your job and you truly find out it isn't as painful or the end as some think it is. Your right, it is a part of life and people are so removed from that. It's a journey, why be afraid of a small part of it.

Reltney McFee said...

For me, it isn't so much "compartmentalize", as, I got other shit to do. If The Boss Wills it, somebody doesn't die, and, maybe, goes home to his/her family. If The Boss Wills otherwise, well, I am but one of His fingers.

You allude to it in your side bar: I try not to be That Guy, "...running around like a headless Nancy".

Curtis said...

As a LEO for the past 17 years, the vast majority of the burnout that I have seen is as a result of poor leadership. An uncaring and bureaucratic, or even worse actively stupid, chain of command can age you prematurely. Tragic deaths are rough to deal with, but most of the deaths that we see are predictable outcomes of stupid behavior.

cyrus83 said...

I kind of fall into #5 - not exactly a CI, but really have never felt completely "well" following a fun medical event that introduced me to a whole bunch of ER, ICU, and inpatient nurses, my first helicopter ride, and a battery of doctors and tests.

I don't really relate to the well any differently than before. My issues, such as they are, are either my fault due to choices or something genetic, in which case, they're not anybody's fault, they simply are. I discuss things with some people close to me, and my doctor is great about both taking and making phone calls as we monitor my condition, but I mostly try not to burden other people with problems that aren't theirs.

Most of the impact is on me - a better diligence over trying to improve my health in ways that I can, a better appreciation for the time I have, and an effort to not be one of those people who is on their deathbed, filled with regrets over things not said, and unable to say them. It may be my boarding time with death is earlier than most, but if not, a wake-up call in one's 30s is better than regretting all of life's choices at the very end in old age.

Crew said...

Hmmm, another by Emily Dickinson I now like.

I also like "I died for Beauty, but was scarce"

It seems to be a tribute to John Keats.

Anonymous said...

Well... If course there are times when death may not be " unwelcome" after a good run when the machine we inhabit starts to really fail. I've been fortunate to be able to converse with and most importantly thank those who have gone before. They didn't give up per se but we're "ready to go". Folks may indeed think me cold, but that's on them.
Boat Guy

Dan said...

Been doing the healthcare thing for 40+ years. Most of what was written is basically the truth. "Burnout" is a real thing in healthcare. It's likely
NOT from the death we's usually from the bureaucratic bullshit we
have to wade through daily, the incessant stupidity we must side step and the
abject refusal to accept personal responsibility too many people suffer from.
Now I must go.....ER has ANOTHER land tuna with a BMI of 50 that needs some
imaging done.

Unknown said...

Dear Aesop, I am a 75 year old retired anesthesiologist and USAF veteran, I spent 43 years passing gas and dragging my stool around the operating room and delivery suite. (A little professional humor there.) I am a long time lurker on this site. I hope that is the correct jargon. Sir, you got it absolutely right, once again.Please know that this is the first time I have ever felt motivated enough to respond to a post on any website. I would consider it an honor to have had the opportunity to work with you.

Anonymous said...

As one who lives due to thaumaturgical level assistance from Snohomish County EMS, the Cardiac surgeons and staff at Providence Hospital, and the grace of the Holy Spirit I give serious thanks every day just for being alive. I do have health issues that qualify me as disabled, but when I contemplate the fact that
1) I should not have made it to the hospital.
2) I was not expected to go home from the hospital when I arrived . My wife called our son and told him to get here most Rikki-tik because I might check out before he could make it.
3) Despite significant neurological damage from being 0 resp. and BPM for about 9 min. I still have functional cognition.
I am grateful for every day I have been alive, esp. since that incident.

My question to you:
How often does defibrillation work after loss of cardiac pumping function, and how many times does it work on the 5th try?

Thanks, and as one who lives due to the dedication and competence of emergency medical staff (and of course the Holy Spirit) God bless you all.

Sanders said...

Little brother is wasting away due to the effects of pancreatic cancer complicated by a gall bladder removal surgery and drains put in from that. The drains keep getting plugged up and the last time they went in to clean them out, the cancer was so bad that they said they couldn't do it again. That means he will get an infection and die in a couple days next time the drains plug up.

46 yrs old is too dang young to be wasting away like that...

Home hospice showed up with a big bag of drugs and weed and pretty much just plopped it down and said to take whatever he wanted to make himself feel comfortable.

June J said...

My mother is suffering from the chronic condition we all face, old age. At 95 1/2 her body is failing rapidly and her soul longs to be with her Lord. As frail as she has looked and been the last few years, I am amazed at how tough her body is to continue to hang on the last few days she's been in hospice care.

As her days unwind, I am thankful for the dedicated men and women in the medical profession who see their job as much more than that and choose to minister to the patient and family during times like this.

For those who are there merely to collect a paycheck and care little for the dying or their families, shame on you.

Aesop said...

@Roger Van Atta:
You did work with me.
Just not personally.
As I've worked with you to the same degree.

Ain't nobody who does this business who got where they are without 10,000 others passing along The Knowledge.

Best Wishes, and thanks for a long and well-spent career.

Bear Claw Chris Lapp said...

Latino I have felt your pain. Mom was 51 traveled the same path but by miracle she lived 2 years. I was told God was preparing us, I think he was right. Cancer sucks took all 3 of my family members brother was early 50's as well. God Bless Aesop and all who have been inflicted and all the posters here.

Jess said...

I usually avoid telling my thoughts about death to most people. I guess it's after watching loved ones suffer from their loss of dignity, and how the glimmer of hope in their eyes faded away. They couldn't get up, and they couldn't go on, yet they were still here awaiting the inevitable.

Their passing was merciful. My sadness was abbreviated with the joy of knowing they were not still trapped in a shell of misery.

We all go. Preferably after a good evening, while asleep, and hopefully: never succumbing after a long period trapped by a useless mind or body.

Old NFO said...

Thank you for chiming in. Your perspective is always appreciated. Re the military aviation deaths, that is on the money. Random shit goes wrong, many times for unknown reasons. I've lost over 30 friends/acquaintances over my career. No fun burying an empty casket. The family never gets closure.

Aesop said...


YW. (Like I could ever shut up.)
Just found it a day late is all. Work before play, and that.