Her son came back today. He shifted his weight from foot to foot. He took off his baseball hat and clutched it in front of his chest, knuckles turning white.

“I think we’d like to donate her organs.”

“I think that’s a great gift that can come from her death.”

“How long would it take?”

“The organs have to be placed first. And with today’s snowstorm, it may take awhile for the surgical teams to arrive. Twelve, maybe twenty-four hours. But she is not in pain any longer. Her brain has ceased sensing and feeling. We’ll maintain her heart and lungs until the transplant teams can arrive.”

“She doesn’t want to live this way. I know that. She said she didn’t want to be on life support.”

“So what would you like to do?”

“I think we have to end this now.”

He gathered about half a dozen family members, his aunts, uncles and his mother’s boyfriend. But he was the only one who stayed until she was completely gone. We closed the curtain while I took out the breathing tube so she looked more like herself. I asked the nurse to turn off the monitor so the family could concentrate on her instead of on the screen. I found myself antsy waiting outside the room with the monitor off. I wondered if I would know a dead person just by physical exam?

I went into the room three times over the course of the next fifteen minutes before I was certain her heart had stopped. The nurses were upset that the family decided not to donate her organs. But I felt that the son needed closure on his mother’s death. He stayed by her side until I told him her heart had stopped beating. I felt no regret or sadness that her heart, liver and kidneys went with her.

After he left, I turned the monitor back on…was she really gone? My physical exam skills were confirmed. I was reassured that had I been a physician at the turn of the century, I would have been able to diagnose a dead person.