I’d like to tell you about him. He died today and nobody had the decency to tell me. I left my books and some paper out on the table in the doctor’s conference room while I was at my noon meeting. Somebody could have taken one of the Post-it notes that usually sit in a stack on the table — one of those small, square, effectively bright yellow pieces of paper — and written, “Dear medical student … your patient died today.” The adhesive on the back of the note would have stuck so that the other end would bob up and down as I walked by and catch my attention. I would have appreciated that. Do you remember if somebody wrote you a note?

He died today and I want to tell you about him — about how he had a tracheotomy that prevented him from talking, but we still had conversations. But, maybe you’ve heard that one. He had “mental status changes” for the past six months. It was the first of his problems I would report on rounds. We described the changes as “waxing” and “waning.” I never found out whether his bad days were waxing and good days were waning or if it was the other way around. He had a tattoo on his right arm. I never could quite make out what it was. I imagine he got it when he was young, when he was my age, and the tattoo blurred with time like ink on paper left in the rain. He appreciated it when I took his hands out of the restraints, even just for a minute, and he always put his hands back in them when I had to ask him to. Maybe you’ve seen that before. He fought with the nurses while trying to grab the tubes he had coming out of every natural and unnatural orifice. And he screamed at me through his trach tube to help him. Never words; I only ever heard the coarse air flow out of the hole in his throat. It sounded like the wind that flows through old, warped window sills with panes that frame the storm rolling along the morning horizon. Maybe you’ve heard that before.

Three days ago, the night nurse said that he slept well, and I felt much better when he didn’t plead to be let out of the bed that morning. “It was nice to meet your family yesterday. Your son looks like you,” I told him. He only nodded back at me. No anger, no fight — just a nod. Maybe you’ve seen that before.

I drew some blood to take to the lab five minutes before his heart stopped two days ago. Maybe you remember wondering if it was you, if the pain from the needle made the difference. What if I had gotten it on the first try instead of the second? Then, the code alarm went off. That damn alarm is so loud. I was in the conference room when I turned away from the desk to follow my resident to where the alarm was calling us. I don’t remember whether I ran or walked, but I ended up in his room. He was blue. I’ve never seen somebody so blue. And he was limp. There were so many people in there, people I had never seen, and people yelling, but I felt like I was alone with him. I don’t know why, but I felt alone. “Get a carotid pulse!” So I did. “Hold onto it!” I wondered for a moment if there was something I could hold, if I could play tug-of-war with this man and his pulse. I heard one of his ribs crack under the chest compressions, as his body bounced off the table mocking the motion of the heart monitor’s tracer that would come and go, rise and fall. I stared at his arm as it moved just after the rest of his body, wondering about that tattoo. He went to the intensive care unit that day.

I’d like to tell you about him; he died today. But, maybe you’ve heard it before.

—Allan Peetz

Allan Peetz, from Osceola, Indiana, is a member of the Class of 2008 who plans to become a Third-World physician.