Quote from tewdles
It is my experience that physicians are not all that great at recognizing the signs of imminent death either...
That really strongly reminded me of a night shift many years ago - I had a patient who was deteriorating, NFR but for full ward management. I had the resident up examining him, more a pro forma
exercise than anything else; the resident was a bit stressed out and needed to do something, so he started preparing to take blood. I tried gently to point out that the patient would be dead before the results came through, without actually saying it in a way that the unconscious (but possibly still hearing) patient could understand.
I think I said something like, "I don't think the lab will be able to process those in time to be useful." Whatever I said, it clearly wasn't explicit enough, because he went around to the patient's other arm, haivng failed with the first one. He got the tourniquet on and said, "I don't understand why I can't get a flashback."
Me: "That's because he just died."
Poor baby resident: "Oh. Oh! Oh dear, if I'd know it was that close I never would have put him through taking blood."
And that's when I realised that most doctors so rarely see patients who are dying that what was obvious to me (imminent death) looked different to the doctor (very ill).