What Death is Really Like.

Trying to make sense of life's most unnatural, natural phenomenon

Certain details have been changed to protect privacy and comply with HIPAA.

Photo by Ýlona María Rybka on Unsplash

I hadn’t even completed chaplain orientation when I witnessed my first death. It was a woman in her early 40’s, young and unremarkable in appearance in almost every way, except her lips, tinted a sickly blue from hypoxia.

My preceptor received the page as we were finishing lunch in his office: I, a graduating Biblical Theology Major; he, a seasoned ministerial professional in grief and spiritual care.

You could see it in his eyes.

CODE BLUE, ADULT. ROOM 1124.

I hesitated. He didn’t.

He stood and tapped my arm. “You ready?”

I couldn’t find any words. I gave a slight nod of my head, clumsily gathered my notepad, stuffed a couple of prayer pebbles — small clay molds with a word engraved upon the surface such as Hope or Faith — into my pocket, and followed him out the door.

When we arrived at the unit, the patient was already receiving chest compressions via a mechanical device called the LUCAS Chest Compression System. The LUCAS machine is a large metal arch that braces over the torso, while a steel piston centered above the sternum drives steady, rhythmic thrusts downward. With each compression, her body seemed to ripple, unnaturally folding and bowing beneath the force trying to resurrect a pulse while her arms dangled lifelessly at her side.

We found the attending physician just outside the patient’s room, his hands behind his back, observing.

“What’s going on?” my preceptor asked, with far more calmness than I would have been able to muster.

“Acute hemorrhagic stroke,” the doctor replied, his eyes locked steadily on the patient. “I don’t think she’s going to make it.” Nurses moved quickly around her, administering epinephrine, checking lines, calling out times, while others stood momentarily still, the tension palpable in their posture.

It is an incredibly helpless feeling, watching someone be resuscitated. I paced outside the room searching, yearning for anything that would ease the situation. I wanted to fix it. Do something. It was a visceral feeling, an incarnate desire to resolve the suffering, breathe air back into her lungs and take a sigh of relief.

I think the desire to fix resides in all of us. To witness suffering and remain powerless is its own unique kind of agony.

On it went.

Whir.

Thud.

Whir.

Thud.

The LUCAS piston hammered away into the chaos. The room held its breath, to no avail.

A nurse called out, “Pulse check!”

Un unsettling hush gripped the room as a nurse grabbed his stethoscope and placed the bell over the patient’s apical pulse. The hush resumed. The doctor’s coat grazed my arm as he stepped back into the room and pondered from her bedside, his eyes rotating between the patient and the big hand of the clock.

“No pulse.”

“Continue compressions then.” The doctor had barely turned back towards the door when the machine resumed.

Whir.

Thud.

The team resumed compressions for two more rounds until at last the time of death was declared.

1427pm.

My fingers found my own carotid artery on my neck as I closed my eyes, feeling my own heart thump against my pointer and long finger, a sort of instinctual reminder that in the presence of death, I was still alive. All these years later, when I witness a patient take their last breath, I still take a moment to find my pulse and recenter myself, a sacred ritual of remembrance that death is ever only a breath away, though now I still remain.

I mustn’t take it for granted.

There was a brief moment of reverence to honor the patient’s life and then the awkward procession of the resuscitation staff (CRASH Float members as we call them) exiting to resume their workday and respond to other emergencies elsewhere in the hospital. There would always be another person. Another story. Another future snuffed out far too soon, yet the fragments that composed them — loved ones, accomplishments, accolades, and possessions would remain behind, lingering on like echoes devoid of their source.

And yet, for many within the acute health force, days like this is simply another day at work. The hospital is a microcosm of life beyond. A subsect of society. A foreign ecosystem invisible to everyone but those who know firsthand what lingers within the walls.

The nurses steadily made their way back to the nurse’s station for lengthy charting on the death, while more returned to other patients’ rooms. It felt so odd to me that life just continued on, while only minutes prior, another’s had ended. Next door, a food service worker entered a room with a patient’s dinner. A few doors beyond that, housekeeping poked their head through a curtain to mop another patient’s floor. The hustle of the hospital resumed, indifferent to the mortal absence we had just tried so earnestly to prevent.

When the room finally emptied, only my preceptor and I remained along with the body of the deceased. The doctor was still trying to get ahold of the patient’s husband. He didn’t know.

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In movies, death is always portrayed as an overly dramatic spectacle. The dying gasp for air, the mustering ability to whisper a few final words, before collapsing gently to the ground as they take their last, hollow breath. The camera lingers. A hand rises one last time, sunlight traces the hollowed planes of the face, arresting the moment. The world seems to stop alongside the viewers until everything, at last, fades to black.

Real death isn’t like that.

Real death is erratic, unscripted, and incredibly peculiar. It is the most unnatural, natural phenomenon in the world. Even when it is anticipated, its totality is deeply felt. No one witnesses death and emerges the same, just as the one who dies will never live again. Its permanence creates a void and yet the world continues on. It’s shocking, and dare I say, a bit offensive. In Critical Care: A New Nurse Faces Death, Life, and Everything in Between, Theresa Brown writes, “This happens: a person’s body reaches a critical point beyond which she cannot be saved or even help, and the individual’s humanity recedes as her physicality takes over. Death is the final stage in that process, since in death the person’s body remains, but her spirit, or soul, the force that animated her and made who she was, is gone forever. Perhaps if our bodies vanished when we died, death would be easier; part of the puzzlement of death is that the body stays, but the person we knew and loved will never come back.”¹

It is the receding that makes death feel so incredibly final. You witness the full complexity of a person steadily withdraw, in slow succession. All that remains is structure. Biology completing its last sequence. The body shuts down like the complex, integrated system that it is, while the essence slips beyond reach. Words can never quite capture the extent of what it’s like to see another human being die. It is a visceral experience that will forever change you.

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At her bedside I finally learned her name. Rebecca. She had glowing blond hair that lay in waves circling her head, like the sunrise at dawn. She looked pale, but not lifeless, still clothed in what she adorned herself with that day, not knowing that she wouldn’t be around to see the end of it. Her eyes were still open, staring fixedly at the ceiling. The chaplain preceptor reached over and closed them with two fingers carefully, making it look like she was simply fast asleep. We circled on either side of her and honored her life, offering prayers and reading Psalm 23 over her as a committal.

There was a soft knock at the door. The nurse stepped back in, followed closely by a man in a light blue flannel who must have been the husband, his eyes glazed over with fatigue and shock. There was a particular vacancy in his posture that chilled me. Some quiet part of him had already died when he received the news. You could see it in his face. He stood before us as a man in body, but something distinct within him was missing, withdrawing from the sharp reality of life without the woman he loved. He had the thousand yard stare, a gaze fixed somewhere far beyond the room, looking through the moment rather than into it.

I watched the doctor come back in and report the story to the man; the resuscitation efforts of the team, the medications administered, the futile prognosis that stayed the doctor’s order of a fifth violent round of chest compressions. In the end, the husband spoke no words, but remained at the head of his wife, stroking her cheek and tucking a strand of her golden hair behind her ear.

He welcomed a brief prayer, then asked to be left alone.

I never saw him again.

Though I left Rebecca’s case, her case never quite left me. The moment stayed with me, enduring long after the door had closed behind me. Even now, whenever I pass the room where she died, I think of her.

Since Rebecca, I have witnessed hundreds of deaths and heard thousands of stories. People process out loud, giving shape and body to their deepest aches and traumas. I catch it all. Not to fix, but to honor. To receive something uniquely and profoundly human. In many ways, I think that is the defining characteristic of a good chaplain — to hold the space needed for stories to blossom and have room to grow, little delicate seeds of a life well lived, a sacred remnant of a past now memory, and a future legacy just beginning to push up from the soil.

It is a deep privilege to bear witness to such things, one that will never be lost on me.

The most interesting thing that I have come to recognize about death is its universal impact: we all ultimately will die and share the same fate of everyone who has gone before us, and that it will likely look drastically different for each one of us.

There is no guide on dying well or adding more years to your life. Outside of a few modifiable lifestyle changes, ultimately our demise is governed not by our ability to prevent it, but by our very genetic code, a few biological markers, and quite a bit of luck.

I’ve been at the death beds of centenarians who played golf and lived independently well past the age of 100, and I’ve witnessed the deaths of babies less than twenty minutes old. I’ve seen medicinal and dietary fads rise and fall, and I’ve read more books on health and longevity than I can count. I’m no scientist or gerontologist, but I’ve spent enough time at the bedside to know this: death cares nothing for your age, occupation, lifestyle, achievements, political affiliation, or even your most deeply held beliefs.

Death comes for us all, and we must learn, in some way, to live with that truth.

It isn’t that we ought to think of death more than necessary — for what a depressing life that would surely be — but that the certainty of our eventual end ought to stir us toward life. It should grant us the urgency and the gusto to see time for what it truly is: a priceless and ever-fleeting gift. Time spent brooding over death is time poorly spent. Who among us can alter the inevitable? Our days are better given to the fellowship of others, to making memories, and to serving God in the different ways He calls us to serve, knowing that something far greater awaits beyond this life.

But while we are here, while we are temporal, mortal beings, we must face the often cruel and abrupt nature of death. It simply will come to be, despite how desperate we try to flee from it or ignore its grim presence.

And yet hope appears in the most unlikely of places. I have seen it again and again, even in something as primitive and bleak as end-of-life care. It feels paradoxical to say such a thing, and yet it is a reality I have witnessed countless times and know I will witness many more.

No matter how we ultimately pass on, death does not get every part of us. The love, the memories, the prayers, the small acts of care, these endure.

And because of Jesus, we can have full assurance in what comes next, even when the world around us feels cold and final.

Because with Jesus, even death itself has no power.

“Death is swallowed up in victory.

“O death, where is your victory?

O death, where is your sting?”

— 1st Corinthians 15:54-55

1. Theresa Brown, Critical Care: A New Nurse Faces Death, Life, and Everything in Between (New York: HarperCollins, 2010), 32.