HE SOUND OF THE RESPIRATOR could be clearly heard, pumping life-giving oxygen into his lungs. The monitor mounted above the bed showed the regular beating of his heart, but the tracing on the electroencephalograph was flat. It registered only a straight line.

He was so young, only 23. He had been an honor student at the university. Why, two days previously, had he held a gun to his temple and squeezed the trigger?

As I stood near his bed, I could see his blonde curly hair was still matted with blood. The bullet had entered the right temple and had exited above the left ear. His brain was severely damaged. The neurosurgeon said it would be futile to operate. Realizing that hope of recovery was gone, his young wife offered her husband’s eyes so two strangers might see; and his kidneys so that two others might have the precious gift of life prolonged with transplants.

We came from the OR suite to the intensive care unit to transport the patient to the operating room. Kneeling at his bedside, his wife looked helpless. She caressed his hand while tears rolled down her cheeks. The head nurse gently helped her up and led her away.

We proceeded with our task—switched off the monitor and disconnected the leads. Next, we unplugged the respirator. The anesthetist connected the anesthetic machine to the endotracheal tube extended from the patient’s mouth.

Even though the young man had expired, his blood had to be aerated with oxygen to keep the tissues alive until the procedures were completed. We rolled the stretcher down the corridor and into the OR suite. I quickly deposited my lab coat in the hall so I could accompany the patient into the operating room. The teams were ready. We transferred the patient to the operating table and the surgeons began their operations simultaneously.

It is difficult to explain how I felt. I was unsure as to when he had ceased to be a patient and when he had become a corpse. We had performed these procedures many times at the hospital, but it was always with the expectation that the patient would be alive when we completed our work. I was troubled when I thought of what we were doing. By removing both kidneys, the patient would no longer be living. I did not want to face the fact that I was taking part in this ‘killing.’ There was no room for this in my orderly way of life. My nursing education had taught me that we must preserve life, not take it away.

A physician pronounced the patient dead at 1:30 p.m. The cause of death was a gunshot wound to the brain. The patient’s eyes were removed, and the urologist removed his kidneys. By 2:15 p.m. the operations were completed. It was all over. I left the hospital at 3:00 p.m., feeling drained and empty. I continued to see his young face before me, yet I knew his life was ended.

Driving home, I began to think about my philosophy of death. I realized that my concept of death must be internalized in the form of genuine convictions and beliefs. My concept of death was and is shaped by the context of my religious convictions—that death is the beginning of a life hereafter.

My thoughts were directed then to this young man. His life had not been in vain. I thought of those who might benefit from what we had done this day. I could see how happy four persons would be when they received his organs. I could see their families, jubilant with the news that their loved ones had new leases on life. I also found some solace in the fact that, as a nurse, I have the opportunity to encourage families facing similar tragedies to consider donating organs. I seemed to receive renewed vigor with these thoughts in my mind. Truly, this had been a meaningful death.

Reaching home, I greeted my family, sat down with a cup of coffee, and listened to the highlights of their day.

Mary Ann Kohnke, RN
CHRISTUS St. Patrick Hospital
Lake Charles, Louisiana