I See Dead People

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“Because I could not stop for Death – He kindly stopped for me”. ~ Emily Dickinson

Emergency physicians are not strangers to death.  At least once a shift I see someone who is dead or dying. It comes with the territory.  An experienced EM physician can see death from a mile away. They can smell it in the air. Sometimes they’re the only person in the room who notices death standing in the corner.

There are lessons to be learned from every experience in life. Today we will discuss some financial lessons I’ve learned from seeing dead people.

Death doesn’t care about your plans

pen calendar to do checklist
Plan #1: Don’t die

So you were going to work one more year before retiring to Florida to live the good life?  Too bad.  That heart attack on your Monday morning commute has other plans.

Your first grandchild is going to be born in September? I’ve got some really bad news about that headache you’re having in August.

It’s your first family vacation since your cancer went into remission?  What a perfect time to be hit by a drunk driver.

Death is rude and inconsiderate.  He has a twisted sense of humor.  While we’re busy making plans to give ourselves the false sense of control, Death is coming and going as he pleases.

Takeaway:  Don’t get so caught up in the planning for the future that you forget to enjoy the present.  Spend time with your loved ones.  Don’t put off that trip you’ve always wanted to do.  Make that big life change you’ve been dreaming of.  Tomorrow is promised to no one.

Death doesn’t care if you’re rich

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Dead presidents can’t help you.

I work in an oceanfront vacation and retirement community. My town is littered with current and former politicians, executives, lawyers, doctors and business owners.  I am surrounded by people who are used to getting their way through hard work.  When hard work doesn’t help, they are used to buying their way out of trouble.

Death doesn’t care about your work ethic.  He doesn’t care about your bank account, your Porsche or the new sailboat you keep dumping money into.  He only cares about you, and he doesn’t take rainchecks.

Takeaway:  Money is a tool, not a magic wand.  All the money in the world can’t protect you from being mortal.  Rich people deteriorate and die too.  Don’t sacrifice all your young healthy years only to discover that Death is standing at the finish line to cheer you on.

Death can be expensive

I’m not talking about the quick painless death we all assume we’re going to have. I’m talking about the slow circling of the drain.

person in hospital gown using walking frame beside hospital bed
Help!  My net worth has fallen and it can’t get up!

Most of us don’t go straight from vigor to rigor. The slow stepwise decline strips us of our independence. Eventually it becomes difficult to live alone. A nursing home can easily cost more than $5,000 a month. Think you’ll save money living at home paying for around the clock medical aides? Even at $10/hour, around the clock care would cost $7,200 a month.

Takeaway:  Don’t underestimate the cost of healthcare in retirement.  It’s not just the cost of insurance and medications that eats away at your nest egg.  Nursing home costs can rapidly burn through your savings.

Death is a taboo subject

black and white black and white depressed depression
Maybe death is like Beetlejuice: he can’t show up if we don’t talk about him.

I have end of life talks with families all the time. The most common response to “have you ever talked to your loved one about what they would want in a situation like this?” is “No, but they have it written down somewhere”. The second most common response is a panicked blank stare.

No one is talking to their family and friends about dying. Everyone buries their head in the sand. It turns out that when you die at the beach we bury the rest of you in the sand too.

Takeaway:  Start having conversations today with your friends and family about end of life decisions.  It’s not enough to have it written down in a will sitting in a safe where no one has ever seen it.  One day someone will be making a decision about whether you live or die.  It will probably occur at 3AM talking to a doctor they’ve never met in a hospital they’ve never set foot in.

Death can bide its time

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Tick, tock.  Any day now would be fine.

“When I die, I want to die like my grandfather who died peacefully in his sleep.    Not screaming like all the passengers in his car.” ~ Will Rogers

We all like to think we’re going to live a rich full life right up until the end.  The sad truth is that for many people death is a welcomed release that just refuses to show up.  At least once a month I have a patient tell me they are ready to die, despite the fact that they are in the ER for something that is far from fatal.

I won’t pretend to know what is feels like to outlive all my friends and family.  When you’re 95 years old, your spouse has been dead for 20 years, you’ve outlived your children, you haven’t seen a grandchild in 18 months and your last day of work was 35 years ago death doesn’t sound so scary.

Takeaway:  No matter how old you are, you need a reason to wake up in the morning.  You cannot put a price on having a purpose driven life.  We need to constantly find new goals to pursue.  We also need to surround ourselves with people we care about. There’s a reason studies have shown that elderly people who are married, volunteer or have a pet live longer.

For Whom The Bell Tolls

Death is a part of life.  For an emergency physician, death is a part of daily life.  Obviously I like the part of my job where I get to save lives, but even patients who can’t be saved have valuable lessons to teach us.

This job has taught me that I need to enjoy the present and not constantly worry about the future.  I’ve told too many people too much bad news too many times to not realize that one day the tables will be turned.  My goal is to pack my life with so much love and adventure that when Death kindly stops for me I can say “what took you so long?”.

“Eat, drink and be merry for tomorrow we die.”

 

What do you think?  What lessons have you learned from taking care of the dead and dying?  How do you balance living in the moment with planning for the future?  Share your thoughts and comments below.  

 

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25 comments

  1. Great blog article!

    I often tell the story of my two good friends from residency/fellowship (the latter a class of six people), who were dead by age 50. I think because many of us work around it for so long, we feel immune to it. We’re not.

    Like

  2. This article highlights the importance of not just working towards the goal line but enjoying the journey to get there because you have no idea if you will ever make it to the goal line or how long you have once you do. Great post SHS

    Liked by 1 person

  3. The other one is people who are caregivers for demented spouse or animals or farms and “can’t be admitted “ because they have no plan if they get sick hurt ot killed

    Like

  4. Excellent post SHS. When we are young, we don’t even think about mortality. However, as we get older, it starts to creep into our consciousness. I’m currently in the sandwich generation where I have to think about who will care for my children if I die, and at the same time, I also help care for my aging parents. Best to have a plan in place because death is one of the few things in life that are guaranteed.

    Liked by 1 person

  5. Physicians are so goal oriented .
    Your article is a bold reminder that death knows no strangers , never takes “no “ as answer , has no price , is in control .
    I have to remind myself daily to live and enjoy the moment and see the “ good “ .
    Thank you !

    Like

  6. Maybe it’s the pitch-perfect sense of the macabre / gallows humor, but I pissed myself laughing out loud at this article.

    Thank you for my daily dose of gravitas served with a poignancy and wit worthy of a stand up comedian.

    Makes me feel like all my ridiculous plans to make my actual life resemble my ideal life might just be worth it because, you know, death happens.

    With a smile on my face (could well be my last, who knows?),

    CD

    Liked by 1 person

  7. “They’re everywhere.”

    Fortunately, at our Level III Trauma Center, dying patients in our operating rooms are few and far between, but we do get the occasional belly full of dead bowel with a lactate level of 16 maxed out on three pressors type patient where my only job is to get them through surgery so that the appropriate conversations can take place with family and comort care can begin. I do not enjoy those cases, and hate to see a person’s body go through that in its final hours.

    Even with healthy patients having routine procedures, Death is hanging around. Just in case. If we’re not cognizant of his presence and respectful of the very small but real potential for things to go south in a hurry, he’ll swoop right in.

    Best,
    -PoF

    Liked by 1 person

    1. Death is so commonplace in the ED that most EM docs don’t even react when they see it.

      Death is like our janitor, Jerry. We know each other by name. We appreciate each other’s work. Death and Jerry often show up to the same room, but never at the same time. Come to think of it….no one has ever seen Death and Jerry simultaneously! 😱

      This conspiracy goes way deeper than we ever realized! 🤯

      Liked by 1 person

  8. Thanks for sharing about your experiences and lessons learned. Sometimes we are so goal driven and focused on those future goals that we forget to be spontaneous and live in the moment.

    That’s why it’s important to have monthly fun budgets as well 🙂

    Like

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