DO NOT READ (Warning, graphic, R)

About a month ago, I read a news story about a fellow that awoke after spending 20 some hours lying in a morgue cooler.  Apparently, this fellow was discovered by his family members and they thought he was dead.  They called 911 or the equivalent and from there this fellow ends up in the morgue.  This story, is so frightening and macabre it would make a great horror movie.  Just thinking about it,  sends chills racing up my spine.

How in the world did this happen?  Who made this horrible mistake?  How on earth did they declare him dead?  And could this happen to me?    Could I fail to recognize when death has occurred?  

Death is not a stranger to me.  In my line of work;  it is inevitable.  I patiently await its arrival. 

When a death has occurred or is suspected, I am notified by phone.   I never know when the call will come. Once I do get the call,  I may have to travel  anywhere from 10 minutes to 60 minutes to reach the home.  Once at the residence, the soul responsibility of determining whether death  has occurred is mine. 

Determining death's presence can be daunting.  Even though I have been intimate with death on countless occasions,  I  still,  carefully go through several steps  to be absolutely  sure  death has occurred.  I  have known  others in my field who often rely on assumptions when determining death.   And I myself... have, at times made the same assumptions regarding the presence of death. 

I mean after all....I have seen it so many times; I know by looking at the person if they are dead.  

Caution, for those who are squeamish or just plain scared, you may not want to continue to read.   In other words....THIS IS THE STUFF NIGHTMARES come from.   BE warned!  
 

The first step I take, is I call the person's name. Then while feeling for a pulse I observe the chest for movement or breathing, then I will listen to their heart with my stethoscope, then I will take the blood pressure, if there is still no response, I will open their eyes and check whether the pupils are fixed and dilated, I may also apply pressure to the eyeballs. While going through all these steps, I have felt whether the body is cold and stiff.  If there is no response and I have gone through all these steps I feel confident  to declare the person dead.

Generally,  I feel much better about determining death when the body is already cold, white and stiff than when  I have a body that is still warm  with some color left.  I suppose the reason is because a cold, stiff body looks and feels dead.  Whereas, a body which is still warm, with some color,  where the  limbs are still flexible can still look and feel alive.  (Sorry, about the morbid description)

This, I guess  has to be one of my greatest fears.    Even  with all steps  checked off,  I still  can have doubt.  Naturally, this is human nature.  For most of us,  seeing a dead body is not a normal part of daily life.  The mind can play cruel tricks on even the most experienced folks who deal with death.    After all, death is permanent.  Once I send you to the funeral home there is no turning back.    Or is there?  

 It was about 3am when I got the call.  Through the phone,  a pleading voice says...."please come quick; I think he has stopped breathing."     I tell them.... OK, I'll be right there and I tell them where I live so they will know about how long it will take me to get there.  

I have no problem finding the home once I locate the street because I can see 15 cars parked all around the drive.   I am not  greeted by anyone.  I  introduce myself as I am walking through the maze of  crying people standing in the yard and porch.  As I enter the home,  instinct takes  over in my quest to find the next of kin.   In this case, the family is sitting beside the bed of the  apparently deceased person. .   After briefly expressing my condolences,  I get down to business of pronouncing death. The time of death is used for the death certificate and I need to establish this as quickly as possible without appearing to hurrying.

I asked the family to allow me to examine the body and proceed with my assessment.  With the family still present in the room,  I softly call his name while feeling his neck for a pulse. At the same time I am looking at his chest for movement and listening for breathing.  When I lift his limp arm to take a blood pressure, I  feel his skin is still  very warm.  Unable to feel a pulse, hear a blood pressure, I open his eyes one by one to check for pupil response.  Both pupils are fixed and dilated.  With one final glance at his lifeless body,  I am confident  to  pronounce  him dead. 

Again,  I  offered my condolences to the family.  The next step would be to notify the doctor of the death.   After that, I asked if the family was ready for me to notify the funeral home so they could remove the body and they said they were ready.  They had spent  many days at his bedside and were exhausted.  They were ready for this to be over.   

After the family members had left the room,  I was alone. The room was quiet except for the distant sorrowful cries of  the family.  I turned off the overhead  lamp which garishly illuminated  the deceased.  Silence filled the room.  I  headed across the room where there was a nice desk with a dimly lit lamp.  I settled myself into the rather comfortable desk chair.    Here I would await the funeral home's call and complete my paper work.  While straining my eyes under the dim light to complete my paperwork, a faint sound  briefly filled the room.  I continued  with my work....  and there it was again,   a faint,  but familiar sound.   I completed my paperwork and peacefully relaxed while looking at a framed photo on the desk.  I pondered whether the young man in the photo was the same man that lay silent on the bed behind me, wondering if he had lived a good life.  I closed my eyes for a moment to rest them,  when I heard the  sound again. 

Immediately, without hesitation I knew what that familiar  sound was. Adrenaline  surging through my body, my heart is pounding;  I can't breathe!   I jumped  from the chair leaving it spinning. As I spun my body around to see him,  my eyes were focused on one thing only,  the chest.   This loud, panic filled voice in my head is telling me to...  LOOK AT THE CHEST!     THE CHEST!      LOOK AT THE CHEST!    IS... IT... MOVING?    IS... HE BREATHING?

MY GOD !    IS HE ALIVE!!!! 

I  have no recollection of walking to his bedside from across the room.   In a flash, I was standing over him, staring at his chest and face for any signs of life. There were none.  His body lay quiet and very peaceful in death.   I slowly released the grip of my clutched hand from his arm and realized I had become an unwitting victim of my imagination.