Earlier this week, I witnessed dying. There's this phenomenon called "air hunger." Even if a patient is obtunded, you can still see them gasping for air. Their lips curl inward and their tongue sticks out a little while you can see the muscles in their neck working to help them breathe.

The family knew her time was coming based off the glistening of tears in their eyes. But this was the type of family that held onto hope until the very end. They requested that she receive suctioning of her mucous to help her breathe more comfortably. When suctioning didn't improve her breathing, then they actually finally accepted it. The glistening in their eyes became full on sobbing and wailing. They held her head up in grieving and wiped her forehead with a damp towel.

My tear ducts have a physical reflex when I see others crying. I was able to control the tears from running down my face for a few minutes, but the family's full on sobbing eventually got to me and I had to step out of the room. Then when the whole team regrouped afterwards, I had to let my tears flow freely for a little bit. The team was supportive asking me if I was okay. I was okay, I just can't help but cry sometimes.

The family was Mien. And I felt that extra connection to them being Asian. I thought about my very stoic uncle who practically never shed a tear for his wife who committed suicide. He wasn't heartless, he was the eldest male in m Asian family, he just doesn't cry.

And I thought about David's grandma Betty who had to be on a BiPAP machine to help her breathe while she was dying. I didn't notice the air hunger at that time, she had been dying for months, so I didn't notice that she was actively dying the last time I saw her. For my patient, our team said that a BiPAP machine would be unethical/harmful/uncomfortable. It was probably true for Grandma Betty.

I'm going to be dealing with death a lot in my career. And for professionalism sake, I should try to keep my tears under control. But I'm trying to imagine what my reaction would be if I were the patient's family and I saw the doctor shedding a little tear. I don't think it would be so bad. I think shedding a tear is okay. But only a few tears, doctors have to maintain their composure. Have to.