So, it had all started pretty routinely, earlier that same day. It had been one of those, you know, “dragged a comb across my head” (thank you, Beatles) days, pretty routine. Except that evening I had gone to bed nauseated (was that the pecan waffle I had at Camellia Grill coming back to haunt me?), but I was able to rapidly fall asleep, exhausted from the day. I awoke abruptly about 30 minutes later, and man, did I have to vomit. Right now!
I got up to begin the journey of about 30 steps to throw myself over the toilet, but I never made it. About three steps short of my goal, my consciousness began to fail me, like a guttering candle flame. “Oh, this is what it’s like to faint,” I remember thinking in an oddly detached sort of way. I abruptly found myself naked (yes, I’m a liberated guy who sleeps naked; or more accurately, I was at the time), lying on my back on the bathroom floor, feeling clammy and sweating profusely. The sensation of the coolness of the bathroom tiles was surprisingly pleasant on my skin, as it made me feel grounded in something familiar, which was oddly reassuring, as I had no idea what would happen next. For the first time that I could remember, “I” (I put that in quotes because at these moments, one is not sure what “I” is) was a spectator inside my body, and I was not sure where it was taking me.
Fast forward to about an hour later, and I’m entering the emergency room of a local hospital with my wife. It’s about midnight, and everybody, including the staff, really just wants to be in bed, somewhere, like the rest of the world at these ungodly hours. I had told the older, clinical-combat-grizzled female nurse that I was really nauseated, felt like I was going to vomit, when she asked why I had come to the ER. One look from her said it all—“Yeah, yeah, do you know how many times I’ve heard this in my career? Why are you bothering me, you wimp? You’re a doctor—you should know better. Go home. Go to bed. Call somebody in the morning.” Okay, we’re talking “tough love” here, not Florence Nightingale. You know, modern medicine.
Then she took my blood pressure, and all hell had broken loose.
In less time than it took to comprehend what was going on, I had been put flat on my back (again), this time on a gurney, and was being wheeled around as various things were done to me in rapid succession. An intravenous line had been inserted using a large bore needle, so that they could get the fluids in fast. Next, they attacked me with what is affectionately referred to as a “snake” in medical slang or NG (nasogastric) tube. It’s like a garden hose that gets threaded up your nose, then down the esophagus (the swallowing tube connecting the mouth and stomach), to get to the source of my troubles. It seems that I had perforated an ulcer in my upper intestine, and I was bleeding—fast. A medical emergency, that has about a 25% mortality (I didn’t know that number at the time, but I knew enough from my medical training to know that I was metaphorically treading water in the deep end of the swimming pool). In a strange way, I think I was a bit protected from fully processing the gravity of my situation, because the damn NG tube hurt so much that it was hard to think about anything else at that moment. The sensation that an NG tube produces in one’s skull is hard to describe—imagine a passerby striking one of those big kitchen matches and cramming it up your nose, while it is still flaring. Got the picture?
At the periphery of my vision, I could see the strained face of the gastroenterologist as he was using the NG tube to suck my blood (freaky!) out of me. It stained the NG tube crimson—the color of fresh blood. And now came some really bad news. My blood pressure was dropping further. That’s when they put me in the Trendelenburg position on the gurney. It’s sort of like standing on your head, and it’s done so that whatever blood you have that’s still available gets to stuff like your heart and brain—you know, the organs that are not considered optional for survival.
In that moment, my denial broke down completely, as if a wave of reality had abruptly smashed it. I realized that I could be dying.
That these could be my last moments on earth.
Now, as a physician, I had been around many times and watched people die. It has always been the grimmest aspect of this profession for me. However, as I’m sure that you can understand, when it’s you that’s doing the dying, it’s a totally different experience from watching somebody else do it in front of you. Previously, my experience had been that dying is kind of a group activity in a hospital. Orders are being shouted, people are flying around—there’s very little time to think. But since on this particular night, I was assigned the role of the one “done to,” rather than the one doing the “doing”-- it was a whole different experience.
The immediate reaction was one of panic; it was literally a physical sensation like that of sticking one’s finger in a light socket. It seemed to roll through my body as if every cell was getting the news, “Boys, this could be it, the boss is throwing in the towel!”
What happened next was more interesting. First, everything in the room suddenly seemed beautiful and mysterious, as if I was seeing it for the first (and perhaps last) time. I wanted to remember every little detail—the stubble on the male nurse’s chin just a few inches from my face, the sound that the Styrofoam cup made as he picked it up to take a sip of coffee (I realized even at the time that as I was struggling to stay alive, he was struggling to stay awake). The lights on the monitors were especially captivating in the semidarkness of the ER—they looked so much like friendly little stars, twinkling in the heavens above me.
That was when a second “thrill” shot through me--the sudden awareness that if I died, I would do so totally alone. There would be no one there with me to face this journey. Now, I’ve often heard the experience of being born and dying compared to each other in some mystical, transcendent, oh-it’s-a-big-circle kind of way, but based on my visit to the ER on this night, I can tell you there’s a clear difference. When you’re getting born, you may have to slide that last few inches through the birth canal to touch down on this earth on your own, but upon arrival, you are welcomed into the family of man—love it or hate it.
But when you’re dead, you’re punching out on the time clock, leaving the party. After a few days in a refrigerator somewhere (even that gives me the creeps—I’m claustrophobic), they get around to planting you in the ground. Or torch you, then throw you on the ground. Or cut you up in little bitty pieces like the Tibetans do, so the birds can take off with you. And if you’re lucky, someone comes and visits your grave on a day that’s not too busy, and maybe even sheds a tear over you. But eventually, even they quit coming, no matter how great your accomplishments, or how many people loved you. It all ends the same way, for everybody—alone.
So, as I said at the beginning, maybe I just didn’t get dead enough to get to the entertaining part, what with the lights and the deity of your choice stretching out their hand to me. For me, the only hand that stretched out on that night was that of my wife, as she sat there next to me. There was a poignancy to the magic of our hands touching in that moment that I hope I shall never forget.
In the years that have passed since this experience, I have become certain of a few things. If the folk who believe in an afterlife are right, with the act of death you're merely moving from one life to another. There is no death. If the atheists are right, you're just going to sleep. Sleep is wonderful. So either way, there is nothing to fear.
I am impressed that there is a certain wisdom to death, if you accept the principle that everyone should get a turn (remember this from kindergarten?). What I mean by this is that if you view the experience of life as precious (and I do), and unborn souls are to come into this world, somebody's got to make way for them. That's you and me. The philosopher Thomas Hobbes nailed the problem, explaining that this little earth ship we're flying around on in the vast nothingness of space has only a limited ability to support life. Do the best that you can with the time that you got given on this earth, then move on! Give somebody else a shot at it, and as my Dad used to say, don't let the door hit you in the butt.
Finally, I am certain that for the moment, I am alive. I am not alone.
