4 Main

I think the hardest part about being the senior medical resident is covering 4 Main at night.

4 Main is our palliative care unit. It is the place where kindness is recognized as more important than advanced cardiac life support algorithms. It is the place where morphine, not Timentin, ranks as the most prescribed drug. And, of course, it is the place where patients die from terminal illness.

It is not dying itself that bothers me. I have witnessed many patients on the medical ward die. Some go quickly and without warning; their bodies are found. Others are discovered in the process of dying, and their journey to the hereafter is delayed by the tubes and lines inserted by the code team. Of course, some go agonizingly slowly, praying only for release from their suffering as each sunset falls. Then there are those who go peacefully, as if in their sleep. Each of these deaths has its place, and I myself have a place in them. Laying stethoscope to silent chest is somehow a fitting close.

At 2 am I am paged to 4 Main because Mr. S. has died. I enter a room I do not know and find a family I do not know surrounding a man I do not know. I put my stethoscope to a chest that has never been alive to my ears and I find it deafeningly silent. I wave a flashlight in front of pupils that have never reacted to me, and they stare back accusingly. When I leave the room, the family is relieved that there is finally closure and an end to his suffering.

But for me, there is no closure on 4 Main. I wonder about the young woman at his bedside: Is she a niece, a granddaughter, or a second wife? I wonder about the small cuts on his finger: Was he an avid reader, or the victim of dry hospital air?

Mr. S. should be the protagonist, but I do not know him well enough.

That is the problem with 4 Main.