first dictation

So, I had to dictate today. You are probably thinking, so what? No big deal, right. Well, the only reason that you ever have to dictate in the ICU is if you transfer someone to another institution, or (more commonly) you transfer someone out of the ICU PERMENANTLY (i.e. transferring them to the ICU in the sky).
We had a family meeting today with one of our patients. It was decided at the meeting that the patient wouldn't really have wanted to live like this and had actually expressed so to his family before all this happened. The patient was also able to communicate his wishes. So, we took out the endotracheal tube, and within mere minutes he was gone.
I was asked to "pronounce" the patient. I have never had to do that before. I have only read about it and knew the basics (no heart beat, no respirations, pupils fixed and dilated, no blood pressure, no response to pain). Pretty straight forward. The problem here was that on the monitor the pacemaker was still running, so it looked like his heart was beating. However, if you listened there was no heartbeat. Kind of wierded me out. I thought that it had to be turned off before I could really pronounce him, but apparently not. My attending said that if you were to go to the cemetary, there would be lots of pacemakers clicking away. That also weirded me out. In fact, the whole experience of "pronouncing" the patient creeped me out a little. The patient had just died and so was still warm, but looked dead, and had no signs of life on examination. I think it was the body temperature that was the most disturbing. Dead people are supposed to be cold.
Anyway, the dictation is done, although not very eloquently. Now the family can begin the grieving process.