July 4, 2019 0 By S Harachand

By Daniela Lamas
pp 115


How long can a Facebook post linger after a person’s death? This was the thought that passed through the mind of an intensive cardiac care resident as she was getting into bed. The resident, who was hardly a year into practising medicine, just saw an unanswered post from a patient amid too many condolence messages when she logged in, perhaps after an interval of several months. The post was from Sam Newman, a 28-year-old man with severe heart failure. She only had a brief encounter with Sam during his months-long stay in the critical care unit. She has been asked to pull out a central line catheter as he had developed an infection. While doing the procedure, they had a small chat that drove her to his Facebook page. After accepting his friend request, she glanced through his profile and the pictures he mentioned. When she saw his message once again, the resident prefers not to respond. In fact, she was refraining from it deliberately as a doctor to a patient.

Sam died waiting for a transplant for his progressively deteriorating heart. He was single.

But the unanswered Facebook message kept on coming to the mind of the doctor “at predawn hours and at the murky moments between sleeping and waking”.

The search for why something about their exchange and her silence haunted the resident is the theme of Dr Daniela Lama’s book – You Can Stop Humming Now: A Doctor’s Stories of Life, Death and In Between.

As a resident at the intensive care unit, Dr Daniela had earned a reputation for her hard work. She wouldn’t let any of the critically injured, severely sick patients in the unit die. She would do whatever possible with technology to keep the heart beating. As a budding doctor, she was excited to learn about the newer possibilities that unravel in the field of medicine and hoped to be a part of those remarkable advances.

In a critical care unit, almost all the decisions are made for the patients as the seriously ill patients are probably unable to do so, and the patients’ scared families are repeatedly assured: “We are doing everything!”

At the end of the day, in the negotiation with the patients, the doctors realize that survival was all that mattered.

But survival was just a start. There was an entire range of possibilities and outcomes beyond the stark life-or death dichotomy. The doctor wonders what her patients might face after leaving her care. She wants to know whether they would regret the decision that had been made for them.

Daniela explores these questions as she explains to her non-clinician friends how one step of declaring death actually requires doctors to stick a piece of gauze in the person’s eye to make sure he doesn’t blink.