Only a third of the responding emergency physicians had had any residency training that addressed the issues of the dying patient. As doctors we are enamored with our numbers and statistics, even in the face of such overwhelming emotional pain. The physician may give physical comfort to the family if the physician is comfortable doing so. As lifeless as these guidelines sound, at least they attempt to address a yawning deficiency in medical education. The fifth edition of the study guide makes strides, albeit stiff and regimented ones, in this direction.
Previous editions have no chapter at all concerning death notification.
And as death itself has become more familiar, so too has the agonizing, yet crucial task of informing the family. As in closing a difficult wound, suturing the fractured and bleeding layers of skin together, it takes patience and care to ensure proper healing. If done poorly, the wound can remain open for years. I am no longer afraid of the moment when I must face the uninformed survivors. Now as I walk toward a huddled family or a terrified spouse, I know I am treading on the last few seconds of their before, and with me I bring the painful after.