The Warm side of Death

Being in the medical field has some quirks.

Let me rephrase that.
Being in the medical field involves several profoundly unsettling, surreal, perspective-altering experiences. Over time, those experiences become so frequent and so familiar that they stop seeming profound and, instead, begin to just seem like quirks.

For example, in the normal lives of regular people, our interface with death is usually in the context of a loved one passing away. One day, your relative, friend, or pet is alive and warm and here. The next day, he is cold and gone. The encounter is personal, and we experience it from the Warm side. I'd hazard a guess that most people (maybe all people) who've been to a funeral have found themselves thinking that the Cold waxy figure in the coffin is not the person they knew. The person they knew was Warm. People who believe in a religious afterlife tend to picture reuniting with their loves ones Warm. It's the only way they've ever known each other, and it's how they envision knowing each other again.

During medical school, there's a major paradigm-shifting experience of learning human anatomy through cadaver dissection. Somewhere, a family knew and loved a Warm person. There are photos of them in an album. There are people walking around with memories about them cracking jokes at work or celebrating wedding anniversaries or teaching the grandkids to make sugar cookies. But by the time they generously donate their body, and by the time that body reaches the anatomy lab for a new academic year, it is already on the Cold side of death.
As med students, the Cold side of death was made easier to navigate by the fact that we had never known this body as anything but a cadaver. No name, no past, no story. There were troubling days -- the day when we saw our cadaver's face for the first time, or when the group at the next table realized their cadaver had nail polish in a soft shade of pink -- days when eerie echoes from the Warm side of death snuck through into the anatomy lab.  But most of the time it felt surprisingly un-conflicted; routine; normal. In fact, I got so used to the Cold anatomy that my first time in an operating room for surgery I was caught off guard by the patient's internal organs being so warm and soft.

For the 3rd year of med school and beyond, we're back among the living. The patients may be sick or struggling, but they are alive. They are still on the Warm side of death. The side where a family brings flowers to set on the nightstand, and church groups are sending thoughts and prayers. The side where you have long end-of-life discussions with the patient and her loved ones in order to make hard choices proactively. The side where a lady who happily chatted with me while I examined her during morning hospital rounds suddenly codes after breakfast and can't be revived, and the hardest phone call in the world has to be made to her family. The Warm side of death is fraught with difficult emotions and impossible decisions and an inevitable time-stamped endpoint.

I've been working exclusively on the Warm side since 2008.
A few weeks ago, I ventured back into the Cold in order to collect tissue from an organ donor. After 8 years of knowing patients, caring about them, watching them weeping or bravely smiling, winning or losing their fights with disease, it was nearly impossible to turn the switch in my mind back to functioning in the impersonal world where a body is a body instead of someone's father/brother/friend. All around me, the morgue employees were bustling around in the routines of their day, well-adapted to the Cold; moving this body to the cremation furnace; rolling that one to the embalming room; deciding whether to use a purple-tinted industrial preservation chemical to offset the jaundiced hue of the skin; wrapping the other body in plastic for transfer to the funeral home.

No name, no past, no story.
I was lost.

Being in the medical field has some quirks.