It was raining when I left the hospital. Perhaps the rain marked new beginnings for a soul recently gone or perhaps it was simply droplets falling because the clouds were too full to hold them. Death wasn’t new to me. My years in emergency medicine prior to starting medical school ensured that. I’d felt and smelled death before. I’d contemplated its inevitability and its conflicting identities of tragedy and blessing. Some of the deaths I’ve seen were sad beyond measure and some peaceful.

This patient’s death, the one I’d witnessed just before stepping into the rain, was my first as a doctor. For the first time it was my job to do the exam that declared the patient legally dead. It was my first time stating the time of death and filling out the paperwork declaring death. It was my first time calling a patient’s family to deliver the news that their loved one had died. I’d wondered how long after starting residency it would be before I would complete these somber duties for the first time. Now I know, 8 months.

It was one of the easier deaths I’ve witnessed. It came at the end of a long life. It was expected given the patient’s condition. In fact, just that morning, I’d started the patient on medications to keep them comfortable as they entered the home stretch of their life. I’d spoken to the family as they visited that day. As I walked in the rain, I couldn’t help but wonder if the patient had waited to hear their family members’ voices one last time before giving in to rest. After all, the patient died only hours after their family left the hospital. Their family wouldn’t see them again.

When a patient dies, we complete a discharge order, note summarizing what happened during the patient’s hospitalization, and progress note describing the circumstances of their death. This paperwork makes the process of death much like any other administrative task a doctor has. Yet, though technically similar, these notes feel different. Unlike other daily progress notes and summaries of hospital stays that fill patient’s charts, these death notes are not just a chapter but a conclusion and, because of this, they seem more important.

The inside of my car was fogged when I got in. Somehow the rain had cooled the outside while the warmth of the inside of my car lingered. I turned on the windshield wipers and blasted the air. I couldn’t really see but I decided I could see well enough to start slowly rolling forward. The rain drops bounced off my car. As I drove in the rain, I became sure that it marked new beginnings for a recently passed soul. Nothing else could possibly make the sky weep so beautifully. I wonder if the person whose soul had passed believed in some kind of afterlife. I imagined them observing my little car driving through the rain from wherever they were. I hoped they were happy. At least I knew their troubles in my world were done. May they rest in peace.