Recent events pertaining to death and general freaked-outedness (story of my week) have led me on a trip down memory lane, to that sunny afternoon four years ago when, for the first time, one of my patients died.

I was only a few weeks out of orientation, working as a unit secretary on a surgery floor that deals primarily with cancer patients. Not a lot of people actually die on that floor; if they are terminal, they know they’re terminal and they go home so they can die in peace, without us jabbing them with needles and force-feeding them green jello. Usually, the people who actually die on that floor are the ones who surprise us.

Mr. Patient wasn’t a surprise – we knew he was going, he knew he was going, and the plans were in place to discharge him the next morning with hospice. He just jumped the gun a bit. When his son came up to the desk an hour after my shift started and asked if he could see the doctor, I told him the doctors would be in soon on rounds. I had been taught from Day One that one does not interrupt the doctors in a discussion (as they were at that very moment, right behind me where Mr. Patient’s son could see them but thankfully not hear them, since they were talking about golf). He said again that he really needed the doctor to come to the room, and I explained again that the doctors would be in very soon, it was almost time for rounds, and could I get the nurse to bring him anything in the meantime?

He leaned across the desk and scowled at me. “Well,” he said loudly, “my dad just DIED and I think I need the DOCTOR to come in and pronounce him.”

The golf conversation screeched to a halt and I sat down, speechless as the doctors clamored around and looked at papers and asked questions and finally went to see the patient’s family. I knew there was something I was supposed to be doing… ah yes, there, in the back of my orientation manual was the Expiration Checklist. Okay…notify physician, that’s done, call spiritual care, will do, call expiration tech…

“What’s an expiration tech?” I wondered aloud.

“He’s the dude with the body bags,” said the CNA, passing by my desk with a cup of juice for one of our live patients. “Bags and tags.”

What a job, I thought. I called spiritual care, the expiration tech, the nursing office, the clinical manager, everyone on the list – check, check, check. Spiritual care came and consoled the family, a social worker appeared to suggest funeral arrangements – it all went on around me in a blur as I went back to the daily grind of answering the phones, processing orders and scheduling exams.

About half an hour later, admitting called. “We have a patient for room 25,” the girl said.

“Um, 25 is still…occupied.”

“You discharged Mr. Patient thirty minutes ago.”

“He died. He’s still in there. The family needed some time and the expiration tech–”

“Well, I’ve got a patient in the Emergency Department who needs a bed on your unit now, and that’s the only one open. You guys need to move that guy out of there, NOW.”

Click.

I told the charge nurse, and miraculously, the family cleared out and went into a meeting room with the chaplain and the social worker while the expiration tech bagged and tagged. Or so we thought.

The orderlies rolled Mr. Patient by my desk on a stretcher with a sheet pulled over the raised rails so the outline of his body was obscured from view. Away they went on the service elevator, just as a housekeeper showed up to clean the room. The expiration tech filled out some forms for the chart, handed them to me and left as the patient from Emergency rolled past my desk and into room 25. It was perfect timing.

A few minutes later, the service elevator opened and a confused-looking orderly pushed the stretcher-with-a-sheet-over-it back in front of my desk. Mr. Patient had returned.

“Why are you here?” I asked him. “Why is HE here?”

“Uhhh,” he mumbled. “They said the tags was wrong and to bring ‘im up, so I brung him.”

He shoved a crumpled transport log in my face. I ignored it. “Who said the tags were wrong?” I demanded, looking around desperately for a charge nurse, any nurse, anyone who had been here more than three months and was better-equipped than I to deal with a dead body in the hallway.

“The guy in the morgue. Could you sign this? I got another trip to do.”

“You can’t just leave him here!” I wailed.

“I’ll put ‘im back in the room,” the orderly said, kicking the brake off and starting toward room 25.

“There’s a patient in there now.”

“Where’s your empty rooms?”

“We don’t have any. Please, just wait while I call the morgue and straighten this out and then you can take him–”

“I’ll put ‘im here,” he said, pushing the stretcher into a corner by the elevators. He grabbed the transport log from me, not caring that I hadn’t signed it, and disappeared.

Breathe, I told myself. Call the morgue and tell them that the idiot orderly just left a dead man by the elevator.

“His tag was wrong,” the man in the morgue said when I called.

“What tag?”

“His toe tag. He has the wrong tag on his toe. That one goes on the bag and there’s no tag on the bag so you have to do them over before we can take him. Go look at it.”

“I am NOT looking at it.”

“Better call the expiration tech.”

Click.

So I called the expiration tech. I explained the situation frantically. “You’ll come up and fix it right away?” I pleaded. “He’s in the hallway, we have no rooms–”

“Those tags are right, it’s that guy in the morgue who’s all backwards,” the tech grumbled. “Go look at the body, there’s a white tag on the toe and blue tag on the bag, right?”

“I AM NOT LOOKING AT IT!” I said again. I couldn’t, physically could not go look at Mr. Patient’s toe. I’m the newbie, the secretary for chrissake, why should I have to go look at the toe? I looked again for a nurse – WHERE were my nurses?

“Call the guy in the morgue back, tell him–”

I mustered all my meager courage. “No, YOU come up here, YOU look at the tags, and YOU call the morgue back since YOU are the expiration tech and there is a dead body in MY hallway.”

I slammed down the phone and a nurse finally appeared. “I need to take Mrs. Brown to CT. Is anyone using that stretcher?” she asked, pointing to the corner by the elevators.

“Mr. Patient is,” I said wearily.

“But he–”

“Came back,” I finished. “The morgue sent him back and said his tags were wrong and there was no empty room to put him in and he’s there and I called the guy and he wanted me to look at the toe but I couldn’t go look, I really couldn’t and so I told him–” I was gasping for breath and trying hard not to cry. “And Mr. Patient’s family is still in the meeting room and if they come out they’re gonna see him and I told the guy and he wanted me to look at the toe, but I couldn’t because I’ve never seen a dead body before and I couldn’t go look at the toe and–”

The nurse was wide-eyed and furious, but as she opened her mouth to curse the expiration tech to the seventh circle of hell, the elevator pinged and he reappeared. Blind to our hysteria, the tech trotted over to the stretcher, unzipped the bag and placed a white tag on the toe and a blue tag on the bag. We watched, mouths agape, as he silently pushed the stretcher onto the elevator and he and Mr. Patient disappeared down to the morgue just as the red-eyed family emerged from the meeting room.

Once again, it was perfect timing. The nurse and I could do nothing but shut our mouths and tend to the living.
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Today I Feel: better
Now Playing: “Midnight Train to Georgia”
Gladys Knight and the Pips