I stood in the doorway of room 414, looking at my new patient, 85-year-old Mr. Herczeg. He was wrapped like a mummy in brown,solution-soaked dressings.
More than anything, I wanted to go home.
Eight hours before, Mr. Herczeg had tried to start a barbecue fire and had been burned over 90% of his body. The doctors still hadn’t decided how to treat him; and for the time being, they had plasma and an I.V. solution running. They’d given up on a heart monitor because it wouldn’t adhere to his burned skin. I could hear Mr. Herczeg struggling for breath, edema was probably occluding his airway. I called the anesthesiologist, and with great difficulty, he intubated Mr. Herczeg. Then, to my dismay, he put him on a respirator. But that’ll only prolong the poor man’s suffering, I thought, feeling responsible because I’d called the doctor in the first place.
After the doctor left, I checked Mr. Herczeg’s vital signs, stable. I wondered if he was conscious. “Mr. Herczeg, can you hear me” I asked. He blinked his eyes. “Are you in pain? Roll your eyes to the left if you are.” His eyes didn’t move. I wasn’t even sure he could understand me, his records said he spoke only Hungarian. Still, something in his eyes made me believe he understood.
My watch said 4 a.m. I needed a cup of coffee badly. But before I left the room, I wanted to take his blood pressure one more time. I listened, nothing. I tried to get an apical pulse, still nothing. Quickly, I called another nurse. She checked his vital signs, but she couldn’t hear anything either.”He’s gone,” she said. “No he’s not,” I told her. “He was stable only l5 minutes ago.” I was surprised to hear my voice shaking. She looked at me strangely, then shrugged her shoulders and called the doctor.
The doctor arrived, checked Mr. Herczeg’s vital signs, then removed the respirator and pronounced Mr. Herczeg dead. But something was wrong; I could feel it. Doctor, I don’t think he’s dead,” I blurted. Maybe I was making a fool of myself; but at this point, I didn’t care. The doctor grabbed me by my shoulders. “Get control of yourself. He’s gone.” Then he just shook his head and went to fill out the death certificate.
“Doctor Franklin, what would make a dead man’s feet wiggle when you tickle them?” “Reflexes,” the doctor said. He sounded annoyed.
I felt confused. I needed that cup of coffee more than ever, but I couldn’t bring myself to leave the room. I had to check Mr. Herczeg one more time. I walked around his bed, wondering what I was looking for. I reached under the dressings to touch his abdomen, it didn’t feel cold. I found myself standing at the foot of his bed, staring at his feet (practically the only parts of his body not covered with bandages). I tickled the bottom of his right foot. It wiggled. I tried the left. Same thing. I literally ran to the nurses’ station. “Doctor Franklin, what would make a dead man’s feet wiggle when you tickle them?” “Reflexes,” the doctor said. He sounded annoyed. But those wiggles had looked too purposeful to be reflexes. I went back to Mr. Herczeg’s room. Suppose he was still alive when they took him to the morgue? And since he’d been hospitalized for less than 24 hours, they’d have to autopsy him. The idea was too horrible even to contemplate. “Mr. Herczeg,” I pleaded. “If you can hear me, please try to breathe.” I put my ear close to his mouth. He breathed.
I was frantic. The doctor, still at the nurses’ station, wasn’t pleased with my question: “How could Mr. Herczeg be breathing?” “The amount of edema in his lungs could cause expiration of air,” he said without even glancing at me. “Then what would cause him to inspire?” I asked. Now I had the doctor’s full attention. He slammed down the death certificate and strode into Mr. Herczeg’s room. I was right behind him. I put my face close to Mr. Herczeg’s and pleaded, “Please, Mr. Herczeg, breathe.” He breathed. Without saying a word, the doctor put Mr. Herczeg back on the respirator and restarted the I.V. I wondered if he’d heard the doctor pronounce him dead 20 minutes before. I prayed he hadn’t.
Suppose he was still alive when they took him to the morgue? And since he’d been hospitalized for less than 24 hours, they’d have to autopsy him. The idea was too horrible even to contemplate.
Suddenly, I felt overcome with relief – and with emotion. “It s okay now, Mr. Herczeg,” I said, and then kissed his bandaged cheek. His eyes filled with tears. “He’s crying, doctor,” I said, and I could feel the tears in my own eyes. “It’s the edema, I’m sure,” the doctor said, but he didn’t sound so sure anymore. Mr. Herczeg died 14 hours later. I’ll never know how much he really heard; how much he actually understood. And I’ll never even know if he felt any pain. But I think he knew what I felt when I kissed him, because I saw the tears in his eyes.