I Watch People Die For A Living: 4 Things I've Learned

Surprisingly, it's bad news if we don't hear the rattle anymore; that means you have the approximate shelf life of pancake batter. Also, much like pancakes, you give off a sweet smell -- the result of acidosis, or the breakdown of internal sugars. Those hospital cats that can predict when patients die? They don't have Miriam Black psychic powers; they simply have a heightened sense of smell.

In your last days, you'll be so divorced from consciousness that you'd drown on a sip of water. That's why many people don't actually die of their illness -- they die of dehydration. But the drying-out process can start long before the loss of consciousness sets in. When your health starts to decline, you'll likely refuse food and water anyway. Relatives might suggest attaching an IV, but I (and hopefully the doctor) will discourage this. Your body may not do anything with the fluid, which means the water could accumulate and result in acute heart failure. With feeding tubes, the solution may do nothing but sit in your stomach, which puts you at risk for a severe infection that'd kill you faster than if you'd done nothing. Trust me, "rotting from the inside out via spoiled Ensure" is not the best way to go.

You can plan them as carefully as you'd like, but you probably won't have any coherent last words. Some people, usually those with some underlying cardiac or respiratory complication, exhibit "air hunger" immediately before death. We also call this "terminal restlessness." You look like you're drowning in the air. You become disoriented and frantic. I'll see you pulling off your clothing, pulling out your tubing, stretching yourself, writhing in bed, crawling or rolling on the floor. You're probably going to hallucinate. Patients on particularly fun medications can see spiders or insects on the walls, but usually it's dead relatives or other phantoms. We recognize that as a clinically significant occurrence that happens shortly before death. We know it happens, but we don't tell the terminally ill that they're not really being escorted to heaven by Air Bud. We're not monsters.

Once, an elderly female dementia patient of mine was shouting at the staff. Then she rolled her wheelchair to the drinking fountain, filled a cup with water, and threw it at a nurse. That's not exactly sociable behavior, sure, but she was confused and dying, and it was just water, after all. That didn't matter. The nurse called for backup, and the two of them wheeled the patient into a spare room. I heard shouting, and peeked in to see that they'd pulled the woman out of her wheelchair and were injecting her with an unidentified medication. It was like watching a Wrestlemania battle royale, if there was ever a Wrestlemania battle royale in which only one person showed up for their entire team, and it was a dying lady in a wheelchair.

Obviously, I wrote up this incident and notified the director of nursing. My job was subsequently terminated. Yes, mine.

I went on nursing elsewhere, where I saw other patients suffering all kinds of abuse. In one nursing home, I examined another dementia patient, bed-bound and unable to speak or move herself. I found she had a Stage 4 pressure ulcer on her right buttock. She had, in the least-metaphorical sense, ripped herself a new asshole, and this facility was using rolled-up hand towels to pack the wound. I notified the director of nursing, and miraculously, I wasn't fired this time. In fact, the director was appalled by the situation. The staff nurse was questioned about why towels were being used instead of wound care supplies, and she replied, "She's going on hospice, so it shouldn't make any difference." When you're going to die, some people take that as license to treat you like you're already dead.

For sending drugs to patients' homes, we use a fairly insecure system: plain ol' UPS. Assuming relatives didn't take the drugs and blame the mailman, a lot of these boxes get stolen off of porches. I don't know how thieves can spot what to steal from the street. There must be mobs of tweakers out there, carefully inspecting every package you get on the off chance that it's medical-grade heroin this time instead of another book about boning dinosaurs (or whatever it is you normally order online).

An hour later, that emergency contact -- a family member -- arrived, screaming loud enough to wake the dead. Which, unfortunately, does not work. Otherwise, that problem would have fixed itself. Soon, more family members arrived -- cousins, nieces, nephews, grand-uncles, dog-walkers -- every one of them hollering and crying. One saw the body and instantly threw herself on the floor, shaking violently. Then she got up and lay atop the corpse, still crying and shouting. Remember, this wasn't the funeral. The patient had died hours before, was not embalmed, and was probably leaking all kinds of fluids.

It was close to 4:00 a.m. before the funeral home arrived to pick up the body and those distraught family members started to leave. That reaction seems Hollywood-caliber extreme to most of us, but maybe that's because we don't have anybody who loves us enough to go Pentecostal at our passing.

Ryan Menezes is an editor and interviewer here at Cracked. Follow him on Twitter for stuff cut from this article and other things no one should see.

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For more insider perspectives check out 5 Horrifying Things Real Dead Bodies Do (Too Weird For TV) and 5 Horrifying Truths About Funeral Homes (From An Undertaker).

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