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First Person

What Death Looks Like

Ho, Amy Faith MD

doi: 10.1097/01.EEM.0000574836.93237.61
First Person

Figure

Figure

This is what life versus death looks like.

This is what medicine versus mortality looks like.

This is what science versus humanity looks like.

After a thoracotomy, a fellow emergency physician, Mitchell Li, MD, snapped this picture of the spilled blood and Propofol on the trauma bay floor.

Blood courses through every one of our veins to sustain life. Propofol courses through our veins when we're on the brink of death.

Ever since I first saw this picture, I have been absolutely absorbed by it. The melding of colors, texture, and story is one of the most striking representations of what we do in medicine.

Propofol is a milky white liquid. Blood is a deep pulsating red that darkens as it oxidizes. The mixture of the two—of synthetic medicine and organic life—intermixing on the narrative canvas of a hospital tile floor creates a chromatic topography that is beautiful in its own right but stunning when paired with its back story.

A thoracotomy is a Hail Mary procedure for fatal chest injuries. The entire chest is slashed open during the procedure, the ribs are spread apart and broken, the sternum hammered through, and the heart extracted from the thoracic cavity, all in the last-resort hope of fixing any fatal injuries found along the way.

It is nasty, brutish, and cold.

The survival rate of an ED thoracotomy is less than 10 percent. When we perform these procedures and use these medicines, we're operating in the purgatory between life and death. Death often wins, and we're left with defeat and the infallible truth of human mortality.

On this tile floor, anarchy reigns in contrast to the methodical movements of the thoracotomy happening above it. Blood spills in complete disregard for tile borders, ripped gloves are discarded haphazardly, battling with shards of glass and specks of flesh and bone. Milky white Propofol douses the entire canvas as overhead lights shine spots on the events we most want to forget.

Life is fragile, and death is crass. Our attempts to augment those truths are frequently futile. Despite defeat, we find some beauty and solace in the fact that such carnage and chaos can create small moments of art and divinity. With a backdrop of profound tragedy manifests a moment of silence, a deepened appreciation of life, a reflection on greater meaning.

These revelations are subtle but poignant, ones we all need a reminder of. Sprinkled throughout our days of death and disease we sometimes find flecks of meaning. This photo reminds us of that, and we all need that sometimes.

This photograph, now titled “Milk of Life” can be purchased athttps://mitchlimd.smugmug.com/EM/with a percentage of the proceeds going to an organization dedicated to preventing physician suicide.

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Dr. Hois an emergency physician, a published writer, and a national speaker on issues pertaining to health care, with work featured in Forbes, the Chicago Tribune, NPR, KevinMD, and TEDx. Visit her website, https://amyfaithho.com, and follow her on Twitter @amyfaithho.

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