This summer’s global health elective reinforced for me the idea that although death may be difficult to watch, the lessons we draw from its experience can be valuable. I chose to pursue a career in medicine after watching my fellow soldiers receive life-preserving medical aid from military medics. The deaths of some of my friends while we were at war further reinforced this choice.
I was excited to work in a hospital in Zimbabwe as part of a medical team. I knew the conditions would be different, but I was unprepared for the severe ailments affecting the patient population at Parirenyatwa Hospital (Pari). Reality set in quickly as I saw a young HIV-positive stroke patient seizing in the hospital bed. The patient began seizing during morning rounds and the diazepam we gave did not stop the convulsions. No other intervention was available, so the seizures continued. As the patient’s breathing became labored, the respiratory therapist came to the bedside and suctioned out the airway. As he worked, I noticed the tubing was filled with blood. I knew then that this patient was going to die. The death I was watching was not that of a quick trauma, but one of slow agony. It was a difficult death to witness.
I was ten years old when my first encounter with death came through a late night phone call. My great grandmother had been battling breast cancer for years, but on that night her battle finally ended. My next encounter was in Iraq over a decade later when I was thrust into the middle of a war in 2006. Following an assault on a building in central Iraq, I was standing on the roof of a house overlooking the surrounding neighborhood when my team leader walked over and asked if I had ever seen a dead body before. When I replied that I had not, he pulled me to the edge of the building to look down at a man lying on the ground, illuminated by a flashlight. This marked my first image of death, one that resulted from the traumatic injuries of war. After this experience I thought that, having seen the worst death has to offer, a death at the end of life would be easier to stomach. Despite this preconceived notion regarding the relative challenges different experiences with death may present, my time in Pari hospital forced me to come to terms with another, equally disturbing form of death: death from chronic illness.
As I watched patients present to Pari hospital in Zimbabwe barely clinging to life, I was reminded of my experiences in Iraq and Afghanistan. This new encounter with death reinforced my commitment to serving others. At the end of life, patients rely on physicians to relieve suffering and provide guidance for the social and spiritual issues at hand. The training we received at Pari went beyond the mere science of pathophysiology and treatment protocols; it provided us with insight into the very human experience of working with patients during their most precious moments. Through them, we learned something of the essence of mortality and grappled with the very real burden such an intimate experience with death can have on a person.