Hektoen International

A Journal of Medical Humanities

Please don’t die in the hospital

Alexandra DeFelice
Falls Church, Virginia, United States

Dead Flowers” by John Brighenti on Flickr.CC BY 2.0.

I don’t like the way people die in the hospital.

I don’t like the color schemes, the paleness that seeps into every empty wall, every window shade, every floor tile; every cafeteria counter, every elevator sign, every parking lot stripe—the paleness, the sterile acceptance, that appears, eventually, in every worker, whether it be their worn-out scrubs, their scuffed-up shoes, their dried-out pens, their burned-out eyes.

I don’t like it. I don’t like it at all. I can’t stand it—

But I can. I have. And I have to.

I have stood and watched the resident place her stethoscope on the chest and her fingers on the wrist (where, under other circumstances, she would find a pulse) and shine a light into the eyes and wait for the attending to say the time of death. I have stood as that time is seen, heard, noted, and I have gone along as we all left, soon enough, only to forget the time. We forget the time because we give it away—to the family crying in the hall, or listening over the phone, or perhaps to no family at all, in which case we leave it with the nurses to do with as they please.

But I don’t like it, and I won’t be able to stand it forever. I can stand it only until I am alone—only until there is no one around to see, hear, note, or judge—at which point I no longer stand but sit, or kneel, or lay, or even fall, because I can’t stand it, or bear it, or keep it inside. But perhaps one of these days, instead of getting out, it stays in. Perhaps it turns solid and heavy and opaque, and it stretches into my veins and sneaks into my heart and steals away all the color. Perhaps one of these days, I will turn pale, too.

I don’t know why we don’t stop them. I wouldn’t mind if, instead of welcoming people in, we tried to scare them away.

The palliative care team gets it. They know, they understand—they have the secret, and they try so hard to share it with us all, but it gets lost in the notes and the consults and the data that accumulates until a death summary appears in the chart to collapse all beneath it and render meaningless anything that dared exist just before.

I wish we would scare them all away.

I wish it so hard that I have flashes—at home, at the hospital; while asleep, while awake—of those whom I love perishing in that most grisly and misconstrued way. And I find myself alone—I make myself be alone—and I grab at my phone, and I hold back the tears while I tell my parents how much I love and appreciate them because if they knew I was about to cry, they’d be worried. And if they were in a car crash on their way to work like the person from the most recent intercom announcement who is on their way by ground with an ETA of six minutes, I wouldn’t want that to be the last thing they thought, should they die in that crash.

And if, instead, my parents lived a long, happy life and eventually grew frail and ill, and the hospital refused to scare them away, I’d want them to know that I love them deeply and to trust me when I fought to keep them out of the hospital—and as we said goodbye right before they took their last breath at home, I’d want them to be comforted by my love.

I can’t stand it.

I had an attending who wanted to know, every morning, why each patient was still in the hospital. We had to justify, as explicitly as possible, why they were not ready for discharge. She would make us fight to keep our patients in the hospital, and I’m not sure if she was trying to save them money, to spare them misery, to give their bed to someone who might find more benefit from it—I’m not sure if, maybe, she had the secret, too.

If she did, she could stand it. But I don’t know if I can.

I want to scream it sometimes. I want to yell. I want to run around the hospital, grab everyone on the team by the shoulders, drag them into the room, force them to face the crowded paleness; I want to kneel at the side of the bed in front of everyone and beg—beg the doctors, the nurses, the therapists, and every caretaker there, and beg the patient—plead with the patient—that they might die somewhere else.

Die as a person, please. Don’t die as a patient. Don’t die as a room number. Don’t let your death be meaningful in that it frees up a space for some suffering person stuck in the emergency department because we just don’t—we just never—have enough room. Don’t do it. Not here. Run away—I’ll help you. Just don’t die here.

I want to beg it of them, scream it at them, plead and weep and request. I don’t want them to die here: I can’t stand it.

I can’t stand it, and I refuse to survive it by turning pale. I’d rather be ripped apart.

I don’t like the way people die in the hospital.

I don’t think anyone else does either.

ALEXANDRA DEFELICE is an M4 at the University of Virginia School of Medicine who writes both prose and poetry. A Louisiana native, she has a B.A. in classical studies from Tulane University. She won the UVA Medical Student Review’s 2021 narrative medicine contest and has received honorable mentions in the Gold Foundation’s Humanism in Healthcare essay contest and the Baylor College of Medicine’s DeBakey Poetry Contest. Her work has also been featured in the Geisel School of Medicine at Dartmouth’s Literary and Art Journal, Lifelines. She has a special interest in trauma disorders and plans to go into psychiatry.

Highlighted in Frontispiece Volume 15, Issue 1 – Winter 2023

Fall 2022




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