I kissed two patients in hospitals before they died. I’m not talking about family. These were people I hardly knew.

The first was my first patient in medical school. Mr. Leakey was a seventy-nine year old male with a child’s face and unruly thinning hair. I spent hours trying to understand his varied complaints of weakness and ankle swelling. Soon I learned he had anemia and I figured he would get better with some iron, nutrition and maybe a transfusion. He lingered on the ward, waiting for tests, and I moved on, anxious to fulfill my other responsibilities.

On the last day of the rotation, during teaching rounds, the chief physician on the service announced quite matter-of-factly that elderly people with certain forms of anemia often have gastrointestinal cancer. “Like Mr. Leakey, for example, who has a large incurable gastric carcinoma.” He said this and he winked at me. After rounds, I went back to Mr. Leakey to say goodbye. I knew I would never see him again, but instead of wishing him well, I kissed him on the cheek, trying to conceal my tears, and left him behind, bewildered.

A few years later, early in my internship, I was covering for another intern and approached a patient, an elderly woman to draw some blood. She heard me in the room and sat up startled and suddenly in severe distress.

“I’m going to die,” she yelled. “I’m going to die,” and she promptly collapsed in cardiac arrest.

I stared at her silent, breathless body bewildered for a moment, perhaps like Mr. Leakey, until I realized what was happening and my adrenaline kicked in.

“Call a code,” I yelled to the nearest nurse and grabbing the pulseless patient, I began compressions and mouth to mouth resuscitation.

Seconds later the code team arrived.

“We have ambu bags for that,” said one of the residents laughing at me. They pushed me aside and continued CPR.

She lasted a few more nights in the ICU, the last hospital patient I kissed before death.

© Richie Smith