In the Emergency Room some days are worse than others.  Today was a very bad day.  There was a single car roll over accident near our hospital.  The ambulance called to report one passenger had been ejected, that is never a good report.

This was an entire family passing through our area on summer vacation.  Two of the passengers died, one at the scene of the accident, one in our emergency room. Two were flown out flight for life and are doing well.

Any physician who works in an emergency room has to give bad news to family members at some point.  I have had to tell family members that a loved one has died or did not survive in spite of our best efforts on multiple occasions.  I found this particular case to be very difficult.  How and when should I tell a surviving family member who is critically injured him self that his wife is dead in the next room?  We intubated her, did chest compressions gave her the best medicines we have available but we could not save her.  Would the shock and grief of the loss further decompensate his fragile condition?  And yet he needs to know the truth.

I imagined how much anguish I would feel if I was told my wife was dead in the next room while I lay helpless and injured on a hospital bed.  I felt an immeasurable grief and sorrow for their sudden loss and we know their grief would be so much more and there will be nothing we can do or say in the moment to lessen the burden.

After I spoke with them, answered their questions, and gave them all of the information I had available in the moment I had to find my way to the hospital chapel where I sat and cried and prayed for a brief time.  Then I had to find my way back to the floor as there were more patients waiting to be seen.

Death is the great balancer of life.  It puts all of our erroneous thinking and confused values into perspective instantly.  Death reveals where we are confused about life and shows us how nature views life – it’s purpose and function.

When I consider life and death in light of osteopathic medicine I ponder Dr. Still’s writings.  He was very clear that death is not the enemy of the physician.  He called our physical bodies the second placenta and he discussed a mysterious force he called the engine of life.

We know that in the oral tradition of osteopathy physicians only named things they could sense, feel and often interface with for therapeutic reasons.  What was Dr. Still feeling when he coined the term “the engine of life?”  How was he communicating with and working with the engine of life when he treated his patients?  This great engine does not end at death.

Some days are harder than others, and yet this great engine of life continues to generate movement and life and potency with out ceasing.  Today I say a prayer for those who have lost their loved ones and I hope they may feel the love the engine of life has for them.