Behind death

It was just one of the busy nights in the E.R. during my residency training. Following the horn of an ambulance, an ambulance stretcher came in with an old man whose face was gray. “68-year-old male, unconscious suddenly about ten minutes ago. After CPR on the spot, still no respiration, no pulse.” the doctor from the ambulance routinely reported, while the nurses moved the man onto the medical bed well-equipped with respirator and monitors. After my superior checked the status of the patient, we were ready to conduct trachea cannulation and CPR following the guideline. Everyone was thinking of the word “death”, but nobody spoke it. Generally, we doctors cannot declare clinical death until we have done everything we can. For this patient with no respiration and no pulse for more than ten minutes, this was no exception.