
Be wise. Be brave. Be tricky.

Dismal thoughts, philological thoughts

There's now slang for necrotizing fasciitis ('flesh-eating bacteria', or 'hospital gangrene'). I heard it from a resident the other day: 'nec fash'. Ugh.

People make up slang for anything with more than one syllable. I'm really all get-off-my-damn-lawn about it. 'Conj'? Is it really that hard to say 'conjunctiva'? 'Rectalize'? 'Pelvicise'? You can't say, 'perform a [rectal | pelvic] exam upon'?

Of course, the word 'exam' was originally slang for 'examination', and no one says 'rectal examination'. I grew up with 'exam', as did you, if you're less than 90 years old or so. Therefore the word strikes us as completely normal, ordinary, and not slangy at all.

We had a murder victim in the ER the other night. Somewhat unusual murder. (There are lots of usual murders in this area, mostly young males shooting each other, but we're not a trauma center, and we see few of these.)

This was the result of a 'home invasion', itself a somewhat unusual crime. The invaders bound two people in the house, a young man and an older woman, with duct tape. The man survived without serious injury, but in the case of the woman, the invaders covered both her mouth and nose, asphyxiating her.

She had a few agonal respirations when the medics arrived, but no pulse, and although they did the expected things, and bought her to the ER where we continued to attempt to resuscitate her, we never got back a pulse or blood pressure, and eventually pronounced her.

A rather horrible death: being asphyxiated suddenly, without warning, without hope or chance for reprieve.

When I imagine my own death, I imagine something like cancer, or a long dwindling death from Alzheimer's and cardiac disease, with lots of time to contemplate the approaching darkness, and make my peace with mortality. But it doesn't always happen that way. Sometimes death is unexpected, sudden, agonizing. This lady was sitting quietly in her own home when criminals rushed in and killed her in a matter of minutes. People sometimes die in airplane crashes like that. The first people who died in the World Trade Center died like that: an ordinary day at work, then sudden agonizing death by fire. No reason, no explanation offered, just horrific agony, then death.

People sometimes die of medical causes just as quickly. Every now and then an apparently healthy teenager will be found dead. Sometimes it's a burst aneurysm in the brain. This is something that a few people are born with. There may be no symptoms until it bursts. Then, if it's big enough, you're dead. No warning, no reprieve. There are rare congenital defects in the electrical system of the heart that have the same effect. No symptoms until you're a young adult, then one day your heart goes into fibrillation, and you die.

My advice is to get your affairs in order now. Whatever thinking you have to do about death, do it now. Make your peace with the infinite. Make your peace with living persons with whom you feel the need. Prepare yourself for a death that may be unexpected, sudden, with no apparent cause or meaning, and perhaps horrifyingly painful.

It probably won't happen.

But it might.
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