NEW YORK — A person’s breath is usually invisible. It’s quiet and automatic, unseen and unheard. It can be so silent that anxious parents hold mirrors next to their newborns’ faces, trying to catch a glimpse of it.

But in the days before death, the nature of breath changes.

Instead of passing through the body unnoticed, it calls for attention. It becomes noisy, hollowed, labored. Clinicians even have a name for it: the death rattle. It’s not something most people have heard, unless they’ve sat at a dying person’s side. Doctors in training, who go through years of coursework learning to keep people alive, might never experience it. And when they do, it can be overwhelming.

A new class at Columbia University envisions something different. The class, called Life at the End of Life, places students with medical aspirations — before they even apply to medical school — with patients at the Terence Cardinal Cooke Health Care Center (TCC), a nursing home in Harlem. The students enter the doors of the clinic knowing that their patients will not get better, and likely never leave.

In an increasingly tech-enabled medical profession, where death is postponed as long as possible, the class challenges pre-med students to confront that ultimate reality, and to learn how to guide patients and their families through it. And along the way it’s challenging their field’s hidebound distinction between medicine and palliative care — between doing everything to keep someone alive, and helping them die with dignity.

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Image: via Flickr  Some rights reserved by ulrichkarljoho

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