Tuesday, August 16, 2011

Downer alert. My B.

People dying is sad.  That prolific statement is brought to you by my current rotation, Neurosurgery: "Where people die a lot."  Not the slogan of the national society, but certainly a reasonable runner-up option.

What I've discovered during my recent acclamation with death is that I find certain deaths more emotional and tragic than others.  This is another obvious statement, but instead of listing some criteria like "people with families" or "contributing members of society", I am basing this off of my emotional experience. I just sometimes walk away from a patient who died or is about to die, and find myself more moved than with a different patient.

The only variable I can seem to cite with some consistency is age.  Social status, family status, mechanism of injury, events leading up to death; all seem to not make a difference, but age fucks me up.  In particular, it's the 18-35 crowd that jerks my soul around.  There is something about seeing someone with the prime of their life torn from them that really gets me.

I realize this is very egocentric, I myself being in this age range, but I think there is more to it than that.  Older individuals have gotten to live an impressive amount of life.  From your 85 year old former paper editor, to your 55 year old father of 3, their death is sad without a doubt, but their life is established and in status quo.  A great place to be, but a plateaued place, at least from a year-to-year view.  But 18-35, that's when you are really setting up the rest of your life.  You are making the moves to get to that plateau.  You are starting college as a theater major; getting promoted to manager; knocking up that waitress; heroine binging your way onto a reality show.  You are a real fucking winner, and no one can tell you different.

Kids are obviously sad; there is so much life lost.  But when I was a kid, I wanted to grow up to be a fire-truck (Ding-ding!), now I want to grow up to be a doctor and I'm like 90% there.  If you robbed me of life when I was 8, then we can just build a new fire-engine.  If you rob me of my life when I'm 28, then we have just lost my realistic future as a physician (and my loans, see you in hell Sallie-Mae). 

People are in the active process of realizing their future.  It's not a pipe-dream anymore.  It might not be glamerous, it might be laying actual pipe, but it's an active, conscious persuit.  It can be painful, and full of introspective self-doubt, but at least it's not boring status quo, like 20 years from now, and it's not dinasaur catchering and wand-makering like 20 years ago.  It's like running a marathon and getting pulled at mile 16.  You'll never know if you could have made it.  And you won't care, you're dead.  But I will.  I care if you could have made it.  I wanted to see how you finished college.  Or even my Caesar salad.  I hear they were going to promote you to manager...

Anyway, back to work.

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