I've Witnessed Hundreds Of Deaths As A Doctor — This Is The Common Denominator
Each one of them has induced eye-opening self-talk about mortality.
Trigger Warning: Death, Child Death, Pregnancy Loss
It started with a pregnant woman who died with the baby still in her womb.
I was posted in the Forensic Medicine department of my med school and my professor had been asked to conduct an autopsy on the deceased. Her body was opened up. Her organs were removed and sent for post-mortem analysis, and her child was kept in a large jar filled with formalin.
Then there was this outrageous alcoholic who was admitted to the ICU.
His eyes were an intense hue of yellow — as a result of jaundice due to the overwhelming abuse of his livers. His family members signed a DNR (Do Not Resuscitate) and I watched him take his final labored breaths. Each one of them said that he was dying. The last one said that he was dead.
This one time, one of my colleagues rushed a patient to the ICU from the ward while compressing his chest in an attempt to resuscitate him. He had collapsed right after smoking a cigarette and dropping a deuce in the hospital washroom.
I could not feel his pulse so I asked the sister to push a dose of adrenaline. As my colleague got tired, I took over and compressed his chest repeatedly. I heard his ribs cracking, but not the sound of him breathing. After many more minutes of trying to resuscitate him, we took an ECG… it showed a flat line.
Another time, this 4-year-old child was brought by his parents with severe pneumonia at 3 AM. Every single one of his breaths was accompanied by a horrific screechy sound. He had multiple chest retractions. My professor immediately intubated him and counseled the parents that their child’s life was at risk.
I was asked to monitor him all night as I saw his condition worsening. In the morning as my shift ended, I went home to get some sleep. I woke up in the afternoon… only to find out he did not.
In addition to these, there were countless other deaths.
Some of them left me disturbed for a day or two. And many others, my subconscious mind wrote them off as "just something that happens in hospitals."
With each death that I witnessed, I grew more and more detached. It was inevitable, after all. A doctor has to grow significantly numb to death, otherwise, he or she won’t be able to function at all.
It’s an occupation-wide defense mechanism. And it crept up on me as well.
Nonetheless, every single death I witnessed induced unique conversations about mortality.
Many of these were concerned with the thought of my father’s mortality.
My father’s a 58-year-old man with multiple co-morbidities like obesity, type II diabetes, hypertension, etc. He’s been smoking cigarettes for decades now. And to top it all off, he’s a chronic workaholic and to this day, doesn’t get proper sleep.
Due to these facts, a part of my mind is perpetually aware and deathly afraid of the thought of his mortality.
That said, these thoughts are kept hidden most of the time due to the facade of everyday life that occupies my conscious mind.
However, even though these thoughts stay below the surface of my consciousness most of the time, it’s as if they’re just waiting for any trigger — any opportunity to bubble up.
And as a doctor, my life is full of such triggers. Every time I witness a death in the hospital, a heart patient, or even someone who has raised blood glucose levels, I get reminded of my father’s questionable health — and consequently — his mortality.
And those moments, those thoughts that you’d rather not have, induce a kind of fear that you just don’t want to deal with.
In these moments, my mind sends in a chain of hopeful thoughts in an attempt to rescue me from my fears. It tells me that while my father has multiple co-morbidities, he takes all his medications regularly. And consequently, all his co-morbidities are in check, if not completely neutralized.
It reminds me that while my father has had a bad diet for decades, his current eating habits are healthier than mine. It also reminds me of the many studies I’ve encountered that say that Metformin slows down aging, and potentially delays death. (My father’s on Metformin due to Diabetes. Yay!? I guess?)
Sometimes, I’m also reminded of my mother’s mortality.
My mother’s a healthy bird with no co-morbidities whatsoever. That said, her elder sister did get diagnosed with triple-negative breast cancer (one of the worst kinds of breast cancer) a few years ago. And since breast cancers have a genetic component, my mother’s at risk too — and she’s supposed to get screened for breast cancer.
However, people don’t often do what they’re supposed to do. And parents can sometimes be frustratingly stringent.
Despite my repeated pleading and begging, she refuses to get a simple, life-saving mammogram done. I’ve fought with her about this, with actual wet tears in my eyes, but she won’t budge. Oh, and did I forget to mention that she’s a doctor too?
Both my parents are doctors, and I recently became one too. And still, she won’t get that mammogram done. She’d rather live in ignorance. The irony is not lost on me.
But then again, every time I get reminded of my mother’s mortality, my mind would send in another chain of thoughts to rescue me from my fears.
My mind reminds me that my mother does lots and lots of extended fasting for religious purposes. In fact, for the past year, she’s been doing an Ekantar — a religious oath in Jainism that means that she chooses to consume food only every alternate day. Every alternate day is a fast where she consumes only water.
While most humans would be intuitively wired to think that a fasting regimen — especially the kind that allows you to eat only every alternate day — must be unhealthy, nothing could be further from the truth.
Fasting has several extraordinary benefits. It reduces the chance of diseases like Alzheimer's, Parkinson's, and several other heart diseases. Fasting also has a direct positive effect on longevity.
And guess what? Fasting is also known to reduce the risk of several cancers.
These facts, particularly the last one, make me hopeful that my mother will live a long and healthy life.
And last, watching someone die almost every other day makes me regularly and acutely aware of my own mortality.
Up until a year ago, I used to believe and hope that I’ll live to be over 100 years. And there are two significant reasons for this.
First, I’m only in my early twenties. I go to the gym regularly. I eat a healthy diet.
I could pretend that I live the life of a fitness freak because "health is wealth." But I don’t. I go to the gym to look good, feel powerful and maximize my physical potential. But no matter the intention, I still receive the undeniable health benefits of hitting the gym regularly and eating mostly clean.
The second reason is our rapidly advancing medical science.
We understand human health better than ever. Our medical knowledge is growing rapidly. So I think it’s safe to assume that the average life expectancy would soon rise by a decade or two.
So I used to believe I have lots of time — decades of time. But do I?
Before working at the hospital, my thoughts regarding my own mortality operated under the assumption that most people live beyond their sixties and seventies. And hence, my own death never seemed right around the corner.
However, things have changed in the past year.
I’ve seen innocent people in their thirties and forties die due to cancers consequent to their genetic misfortune. I’ve seen twenty-year-olds die due to road traffic accidents.
I’ve seen teenagers die due to rare heart conditions. I’ve seen children die due to malnourishment. And I’ve also seen babies that never cried — babies that never lived.
And hence for the past few months, my thoughts on my own mortality haven’t been operating under the assumption that I’ll live beyond my sixties and seventies. In fact, this last year has flipped this assumption on its head.
Now, I’m highly aware of the possibility of an untimely sign of my own mortality.
What if I have a heart attack when I’m only 50? What if I get a lethal cancer diagnosis only five years from now? What if I’m in a fatal car accident tomorrow?
I’ve always known that death was inevitable. However, I’ve now realized that that’s only half of the lesson.
The other half is this: Death can also be untimely. The grim reaper can come to collect your soul much earlier than you thought he would.
Of course, that’s a depressing truth to accept. However, it’s also one that you need to internalize if you want to start living an extraordinary life.
As Confucius once said that "We have two lives, and the second begins when we realize we only have one."
In essence, death is the ultimate lesson because time is the ultimate lesson.
I cannot afford to wait any longer. I’ve got to start doing important things. I’ve got to start living. And so do you.
Spend more time with people you truly love and let them know how you feel about them. Find work you enjoy and build your life around it.
Reignite your curiosity and seek answers to every question you have. Realize your physical, cognitive and spiritual potential and grind your butt off to maximize all of it.
You’re gonna die. Your time on this Earth is going to be over before you know it. That’s the singular truth that can set everything into perspective.
Realize it. Internalize it. And develop a sense of urgency so that you can do justice to your one and only life.
Akshad Singi, M.D. has been published in Better Humans, Mind Cafe, and more.