Nelson’s “wow” makes me think back to my first death. I was a third-year medical student at Mount Sinai. It was a big day for me because my resident was going to let me do a paracentesis.  Patients with advanced liver disease can have something called ascites — too much fluid in the abdominal cavity, which can be uncomfortable and can make it hard to breathe. A paracentesis is a way to remove that extra fluid. You place a needle, and then a catheter, through the skin and muscle under the navel. Then you let it drain into bottles lined up on the floor.  As I was about to start, my patient became unconscious. Someone called a code and what seemed like a million doctors and nurses ran into the room. They did CPR, pushed meds, used the paddles. I had my sterile gloves on, but I was pushed to one side. I heard my patient’s ribs crack under the weight of the compressions. I watched residents bag his mouth until the anesthesiologist intubated him and hooked up the ventilator. Electrocardiogram strips littered the bedside; an intern tried to place a central line in his groin. After 20 minutes the lead resident said: “That’s it. Thank you all very much. Time of death 3:15.”  Everyone left just as quickly as they had arrived, and for a moment, my moment, I was alone with this dead man. Me with my sterile gloves, and him — naked with his mouth open. My eyes filled with tears, and I hoped nobody noticed. I had been so preoccupied by the opportunity to stick a needle into a belly that I overlooked the seriousness of his disease.  I covered him with a sheet crumpled at the foot of his bed. I learned that day that I needed to slow myself down, to appreciate the gravity of the moment, the power of time and the depth and proximity of my work. It was a very big deal.  Nelson comes and goes, and I have a new student. Again, I’m rushing to get everything done. This time I am on the hospice unit and I go in to see a patient I haven’t seen since before the weekend. She is sleeping, and her hair is brushed back from her face. I introduce myself to her son. He tells me he thinks she is comfortable, but had a rough night. I decide not to wake her, because I figure rest is more important than agitating her out of her sleep. I am on my way off the unit when her son calls after me: “Can you come back? My mom wants to tell you something.”  I am back at the bedside. This time her eyes are open. I touch her cool hands. “Do you want to tell me something?”  She holds my hand to her face and pulls me close. “I wanted to thank you for this. Thank you.”  There it is again — another moment, another near miss. I was rushing to get the day started. I would not have awakened her. I would have just moved on to the next thing I had to do. I would have missed the chance to feel the “wow.” It is a very big deal. How quickly we forget, and how lucky we are to be reminded, before it’s too late.  Jessica L. Israel is chief of geriatrics and palliative medicine at Monmouth Medical Center in Long Branch, N.J.  A version of this article appears in print on , on Page F6 of the New York edition with the headline: Slowing Down to Let the Moment Sink In. Order Reprints| Today's Paper|Subscribe
For a doctor, the first glimpse of death and a simple thank you are reminders to never forget.