Yesterday on Twitter, my friend and colleague Dr. Isis noted that she still gets a sense of surprise when she sees “Dr” next to her name in an email. She, Alex Wild, and I wondered what are the experiences that really make you feel like a doctor (in this case, PhD or medical doctor). So I started wondering: what are the experiences that made me really feel like a doctor? Was it the white coat ceremony? Dissecting a cadaver? Wearing scrubs and a stethoscope around my neck? All of those are important steps, and important memories for me. But as I thought about it, I was taken back to a particular night in a particular place.
My residency program had a night float rotation. Three senior residents would be in the hospital from 11pm until 7am (more or less), each covering a different set of patients. We would run cardiac arrests, admit new patients, and put out various (metaphorical) fires. And we would pronounce patients dead. Each of us shared the duty, on a nightly rotation, of covering the inpatient hospice service. On one of my first night float calls, my pager went off, directing me to call the hospice unit. They asked me to come down and pronounce someone dead. I walked down the hall (no hurry, right?), got on an elevator, walked down another hall and into the calm, well-appointed unit, with its gentle lighting, living room couches, aquarium (at least, I think there was an aquarium). The nurses directed me to a corner room. The lights were low when I walked in, and a man was laying in the bed. His color was—wrong. Everything was wrong. I walked over and tried to wake him up, shaking him and calling his name. I took out a penlight and lifted open an eyelid, my fingers resting on his cold, sweaty brow. His pupils didn’t react. I placed my stethoscope on his chest and watched and listened for a long time. There were no breath sounds, no heart tones. He was most certainly dead. I called the attending physician and the family, waking them both, and sat down to do my part of the “death kit”, which included the death certificate. After a few jests with the nurses, I walked back out into the harsher light of the living.
I’d never felt more like a doctor than I did that night.