Prior to medical school, I remember the first time I was called to move a dead body to the infamous yet necessary morgue. “Room 34,” they called it. As if that dimmed the shroud of anxiety engulfing people walking briskly past the unmarked metal door. It was a bustling day at the only hospital in 202 square miles, and as a patient transporter I often didn’t have time to answer pages. As I finished scarfing down a double chocolate chunk cookie, I checked my voicemail. “You have eight new messages,” a cheery, robotic voice rang out. I rolled my eyes in exasperation. “First message,” the voice cooed, followed by brief static. A new strained voice blared through the phone: “Hello? This is Jackie in the ICU. We have an expiration in room seven.” Click. The word “expiration” stung my senses more harshly than the stench of formaldehyde in my cadaver-based anatomy course. I pushed those thoughts from the forefront of my mind, scribbled a few notes, and headed for the ICU.

The patient’s room was cold and sparkling clean, save a few belongings bags neatly tucked into the corner. The IV pumps, no longer whirring and humming, still clustered around the head of the bed. The medical technology could almost pass as intricately carved pieces embedded into an elaborate headboard. Though the body was encased in a thick white vinyl bag, neat and tight red curls encircling the patient’s head peeked out. For a moment, I imagined this person painstakingly and meticulously continuing their beauty regimen despite being confined to the hospital. Was I humanizing them to feel more comfortable? Dead or alive, they were still human, so why did I feel disconnected? Why was there this feeling of “us” (the living) and “them” (the dead)?

My wandering thoughts were interrupted when a nurse appeared behind me. “Are you ready?” I nodded yes and quickly motioned towards the slide board hanging on the wall. “Oh, we don’t need that. The patient expired forty-five minutes ago,” she said in a curt and flat tone. I winced. There was “that word” again. We slid the patient over onto the gurney, a loud thunk following as the patient’s head hit the stainless-steel slab. I cringed and stared down at the patient, looking up as the nurse had already grabbed the patient's personal effects and tossed them haphazardly on top of the vinyl bag. I began to oppose—I don’t think that—but she was already a step ahead of me. “They didn’t have any family members, so you have to take the effects with you.” My stunned expression went unnoticed. The nurse seemed unmoved as she de-gloved, washed her hands, and scurried out of the room.

With more time, I found this particular experience to be the exception and not the rule for healthcare providers, but it highlighted the critical need among healthcare providers for emotional depth, vulnerability, and self-reflection. Every day, healthcare professionals are presented with situations demanding empathy and compassion while simultaneously being pushed to see more, do more, and provide more. With an ever-expanding list of assigned tasks, it is easy to understand why clinical empathy is being dwarfed by the need for efficiency. What happens when you do not have the emotional bandwidth to provide compassion throughout the entire healthcare experience? Whether it is has become a coping mechanism to shield oneself from chronic emotional insults or the providers are just plain tired, the result is the same: The continuum of care has failed the patient when they needed their provider most.

Upon reflection about my experiences working in the medical field, I have found that death is not the enemy. It is not the plague that scours the Earth, leaving nothing but rubble and decay in its wake. Death is not the ultimate tragedy in life. Rather, prolonged and undue harm is tragic. The ultimate tragedy is depersonalization and death without dignity – dying in an unfamiliar and sterile place, separated from the spiritual and emotional nourishment that comes from being able to reach out and embrace a loving hand. Being detached from a desire to experience the things, some of which are not all auspicious, which make living worthwhile. Being alienated from hope is the true tragedy.

I remain unsure of the origin of my disdain for the word “expired.” Is it because it reminds me of my mortality? Is it because this word choice somehow seemed callous and devoid of feeling, like deceased human beings are equivalent to pieces of spoiled meat? The sound of that patient’s head hitting against the steel gurney rang in my head every time thereafter that I slid a lifeless body over.  I am very certain that eerily loud thunk will still ring in my ears when I hit the wards. I had scores of “body calls” after that first one, with one difference: For their final slide, I always reserved a pillow for their head.