Specialist GP Nikki Vadgama provides some tips to make your next paediatric eczema consult easier. She includes a review of new guidelines, resources, websites and medications for paediatric eczema management
Brief moments in the eerie silence of death
Brief moments in the eerie silence of death
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Here at New Zealand Doctor Rata Aotearoa we are on our summer break! While we're gone, check out Summer Hiatus: Stories we think deserve to be read again! This article was first published on 2 March 2022.
Chosen by Virginia McMillan: Thank you, Lucy O’Hagan, for gently laying your hand on the cold face of your deceased patient and saying their name. Another article from our Wellington-based specialist GP who sure knows how to convey emotion
I have often wondered what other doctors do, alone in a room with a dead body. I’ve never seen a protocol.
Death seems to happen overnight, so often I go to examine the body on the way to work. Mostly, now, the dead I see are in resthomes. The body has been laid out, the family gone. The funeral director has not yet arrived; they need me to do my bit first.
The room is always empty and cold, and everything is still. That is the first sign. The lights are off, curtains shut. The person must be dead because there is an unmoving rose lying on their chest, and the clean sheet over their body is undisturbed.
There might be a suitcase, with the person’s life packed up inside. Sometimes a photograph is left out, or carnations given in the last days. But there’s no sign of slippers, or yesterday’s paper, or spectacles, or crochet not finished, or half-drunk tea; these are the things of life, tidied away.
I’m not sure one could pretend to be dead, as once the body cools and greyness seeps in, there is nothing holding the skin up. But still, I stand by the bed and put a hand on their wrist. I don’t remember being taught this. Maybe as a medical student, I watched an indifferent house surgeon view a body in the hospital morgue.
There is an inertness to a body even if it is not yet stiff. You don’t really have to look to see there is no breath, or feel the pulse to know it is not there, or listen to the heart to hear its silence. But I do these things anyway.
These days, it is often someone I have known for many years, although it can be hard to tell in the dim light, their face gone blank. I might have a silent chat to them or say their name, sometimes with an “Oh” before it. “Oh, Freda.” “Oh, Maggie.” “Oh, Bert.” I might put a hand on their head and not stroke it – no, one doesn’t stroke the skin of the dead, that is for the dying – more a light touch.
And then there is a silence. I have done my job, but it’s hard to leave without a brief lingering.
Before going back into the world of the living, I wash my hands and perhaps I look back at them and there is a short expulsion of breath from me, not a sigh as such, more a moment.
This ritual is recorded. “Death confirmed, absence of vital signs.”
It feels as if something else is needed, so I always write “RIP”.
Lucy O'Hagan is a medical educator and specialist GP working in the Wellington region