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
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
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.
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 taskswitched 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
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 convictionsthat 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