Iowa Writes

HILTON KOPPE
Witness


      I had only ever seen one person die before. I mean, really see them die. Last gasp, and all that. Thirty years of doctoring, and witness to only one death. Until now. Now it is two.
      Not that I'm some sort of demi-god super-doc whose patients never die. Of course my patients die. For some, I have had the privilege of midwiving them on their final journey. For others, it was all too sudden and unexpected. It's just that I never actually saw them die.
      I saw their struggle with life. I tried to stem the tide, spit into the wind, keep my finger in the dyke, push the shit uphill, swim against the rip. But as my dear grandmother used to say, "Mein lieber Gott vergisst niemanden." My dear God forgets no one. Despite the best efforts of modern medicine, nature still wins out in the end.
      There had been the timed and documented moments of death in the hospitals. The failed resuscitations. But did I see these people actually die? I don't think so. They were already dead by the time the emergency pager went off. We couldn't bring them back to life. They were not Lazarus. We were not God. I did not witness them die. I saw them fail to rise. Just like nature intended it.
      Rod Stewart was belting out "The first cut is the deepest" around the time I was cut by a last breath for the first time. It was my first night alone as an intern on the male medical ward. James Ward. Spit alley. Full of public patients, veterans from the days when World War 1 veterans were still around.
      Rod Stewart was belting out "The first cut is the deepest" around the time I was cut by a last breath for the first time. It was my first night alone as an intern on the male medical ward. James Ward. Spit alley. Full of public patients, veterans from the days when World War 1 veterans were still around.
      5.30, 6.00pm, they all go. The day staff. The registrars. The other interns. Leaving me with the nurses, and with the enemy, as we used to call the patients.

      I had only ever seen one person die before. I mean, really see them die. Last gasp, and all that. Thirty years of doctoring, and witness to only one death. Until now. Now it is two.
      Not that I'm some sort of demi-god super-doc whose patients never die. Of course my patients die. For some, I have had the privilege of midwiving them on their final journey. For others, it was all too sudden and unexpected. It's just that I never actually saw them die.
      I saw their struggle with life. I tried to stem the tide, spit into the wind, keep my finger in the dyke, push the shit uphill, swim against the rip. But as my dear grandmother used to say, "Mein lieber Gott vergisst niemanden." My dear God forgets no one. Despite the best efforts of modern medicine, nature still wins out in the end.
      There had been the timed and documented moments of death in the hospitals. The failed resuscitations. But did I see these people actually die? I don't think so. They were already dead by the time the emergency pager went off. We couldn't bring them back to life. They were not Lazarus. We were not God. I did not witness them die. I saw them fail to rise. Just like nature intended it.
      Rod Stewart was belting out "The first cut is the deepest" around the time I was cut by a last breath for the first time. It was my first night alone as an intern on the male medical ward. James Ward. Spit alley. Full of public patients, veterans from the days when World War 1 veterans were still around.
      Rod Stewart was belting out "The first cut is the deepest" around the time I was cut by a last breath for the first time. It was my first night alone as an intern on the male medical ward. James Ward. Spit alley. Full of public patients, veterans from the days when World War 1 veterans were still around.
      5.30, 6.00pm, they all go. The day staff. The registrars. The other interns. Leaving me with the nurses, and with the enemy, as we used to call the patients.
      The pager goes. An admission from Emergency. "Old bloke with anaemia. Probable bleeding ulcer. We're sending him up."
      I enter the ward. Grab his file. Draw back the curtain which separate him from the 30 other inmates of James Ward. As I walk to the bed, a man, grey hair, grey beard, pale face, wide eyes, groans an agonisingly long groan as he reaches a desperate hand towards me. Fear! As he dies. In front of me. And there is not a damned thing I can do about it. His final breath. My first death.
      Thirty years later, a second death.
      After hankering after it for my entire career, I was finally on a palliative care ward. No longer pushing the shit up hill, but helping to assist nature do her thing.
      And she was remarkable. Such grace. Such dignity in her dying. Just as it had been in her life. She was ready to die. Not afraid of death. Tired from 20 years of struggle with cancer. Sad to be leaving her family. But ready to go. Definitely ready to go.
      She'd said goodbye to her home. She'd said goodbye to her friends. She'd said goodbye to her daughter who lived overseas, and to all her grandchildren. She'd even said goodbye to her oncologist of 20 years - "I hope you don't feel I've let you down by dying after everything you have done for me."
      I was blessed to be with her at the end. To watch her breath change. From labored grunting to soft sucking. Slowing. Easing. Letting go. It was quite beautiful to watch. Watching her let go. Watching her go.
      But which was the final breath? The last breath in? Or the blowing sigh a few minutes later as her body totally let go for the first time in her life?
      It was an honour and a privilege to be there with her. To bear witness to the end of a good life.
      It has changed me forever.
      What a pity that it had to be my mum.


In honour of Ray Koppe, 28/2/1935 - 24/9/2010
"Our Ray of sunshine, forever in our hearts"

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About Iowa Writes

Since 2006, Iowa Writes has featured the work of Iowa-identified writers (whether they have Iowa roots or live here now) and work published by Iowa journals and publishers on The Daily Palette. Iowa Writes features poetry, fiction, or nonfiction twice a week on the Palette.

In November of 2008, the United Nations Educational, Scientific and Cultural Organization (UNESCO) designated Iowa City, Iowa, the world's third City of Literature, making the community part of the UNESCO Creative Cities Network.

Iowa City has joined Edinburgh, Scotland and Melbourne, Australia as UNESCO Cities of Literature.

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HILTON KOPPE

Hilton Koppe is a General Practitioner in the coastal village of Lennox Head, Australia, and senior medical educator for North Coast GP Training. Hilton enjoys the challenge of integrating wisdom from the arts and literature into both his clinical work and his teaching. He runs regular creative writing workshops for doctors. He is a presenter in The Examined Life conference held in Iowa City.

The Examined Life is a three-day conference in April focusing on the links between the science of medicine and the art of writing and sponsored by the University of Iowa Roy J. and Lucille A. Carver College of Medicine.

This page was first displayed
on April 21, 2011

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