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Declaring your neighbor dead : Ugly situations

Hey all 

First experience for everything. This is the first and last breathe of yours for the day. There is always a first time and a second last chance.

Though declaring a person dead is a simple routine, but undoubtedly a critical moment for a doctor, especially when the person dying is your neighbour. Declaring death is not technically hard but it is weird and sad.
It is an organized step-wise process of patient’s examination to assess the brain functions. 

I take a day off from work. Refuse an exchange of duty of a co worker. Plan to go out to an amusement park gets popped by momma ,the dearest. I switch to YouTube.

Get up. The neighbor aunty called up. Her mother in law is not keeping well. 

Yeah . So ?

Take your stethescope and Walk!

Oh hello , Madam. Not well? LIke what went wrong. Tell me proper history.
I didn’t want to go there for chronic backache! Am ERPhysician !

Just come. 

Ok mom. Get the glucometer , Bp apparatus . Let’s go!

It was only when I walked into the room and saw my neighbor still and utterly silent, her family sitting around the bed.
elderly , chronically ill , bed ridden.

I could not feel any radial pulse in both fore-arms or any pulse anywhere in the body.I placed my hand on her neck and there was not even a quiver.
Since , only pulselessness does not confirm that the patient is dead. In several conditions, pulse may not be recordable.
Then I examined her carotids.

 I placed my stethoscope on the patient’s still chest and waited, watching for her to take a breath, and wondering how to start CPR if I heard anything. I listened to the silence that had taken the place of her heartbeat. 
No heart sounds could be heard.
 No respiratory movements  observed.
Both pupils do not respond to light and the pupils are seen as bilaterally fixed dilated.

It was 40 minutes of unresponsiveness history wise . 80-90 years of age. Rigor mortis started 20 minutes post my entry into the scenario. So I wonder how accurate the duration of unresponsiveness was!

I looked at the clock and spoke the time out loud and said I was sorry again.

My mother kept staring at me. I still don’t know what was on her mind. Her daughter declaring a death. Or the not so sensitive aspect of my job or what. I didn’t ask her either.

I smile again, understanding my job and limitations, alike. My mother steps into the consolation part. I quietly step aside.

I explain them the procedure to procure a death certificate. Go home . Carry on with my routine.
Life goes on.

So far so much! 
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