One of my patients died last night. Time of death was called around 6:00 pm.

I shouldn't have been surprised. He was old and very sick, and had been in and out of the hospital a dozen times over the last few years. This time he had a massive bleed in his L. brain and was completely obtunded. His breathing was labored, and CXR showed bilateral lung infiltrates. Things weren't good, and deep down I knew he might not make it through the weekend. Still, it was the most unsettling thing to look through the ICU list this morning and not see his name there, to manually search for his name and get a pop-up that read, 'Warning! You are entering the file of a deceased patient."

What really gets me is the conversation we had with the family on Friday. They were getting conflicting statements from medicine and neurosurgery and wanted to know what we thought. After a lot of hee-hawing and side stepping, Dr. M tells them:

"Do I think we can keep him going? Probably.
Do I think he will be alert again? Decent chance.
Do I think he will ever regain function on his R. side or speak again? Probably not."

Pretty grim except we couldn't even do #1.

I just feel so weird because I told them I'd be back to see them today and he's not there anymore.