Saturday, February 21, 2009

On-call Liveblogging: Final Exam

In my line of work we perform physical exams all day long. Many of them can be quite specialized; for example, the exam of the patient with eye pain differs somewhat from that of the patient with rectal bleeding.

One of these specialized exams is performed when we are called to the bedside to pronounce a patient's death. There are certain exam criteria that must be met before we can officially declare a time of death, and sometimes it can be a slightly eerie experience. There's often no one else in the room. If this was your patient you may have been examining him or her several times a day for weeks. Often you knew the patient's body intimately, and now you're seeing it in an entirely different condition. There can be unsettling impressions: did I just see an eyelid flicker? am I certain that I don't hear the slightest murmur of cardiac activity? Just wishful thinking, unfortunately. (Although death can be a more dynamic process than one might think.)

Here's hoping that I don't need to perform this exam on tonight's call....

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