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I've been a critical care EMT for the past[br]seven years in Suffolk County, New York.

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I've been a first responder in a number of incidents

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ranging from car accidents to Hurricane Sandy.

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If you are like most people, death might be

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one of your greatest fears.

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Some of us will see it coming.

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Some of us won't.

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There is a little-known documented medical term

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called impending doom.

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It's almost a symptom.

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As a medical provider, I'm trained to respond

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to this symptom like any other,

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so when a patient having a heart attack looks at me

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and says, "I'm going to die today,"

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we are trained to reevaluate the patient's condition.

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Throughout my career, I have responded

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to a number of incidents where the patient

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had minutes left to live

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and there was nothing I could do for them.

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With this, I was faced with a dilemma:

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do I tell the dying that they are about to face death,

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or do I lie to them to comfort them?

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Early in my career, I faced this dilemma

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by simply lying.

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I was afraid.

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I was afraid if I told them the truth,

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that they were dying in terror, in fear,

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just grasping for those last moments of life.

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That all changed with one incident.

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Five years ago, I responded to a motorcycle accident.

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The rider had suffered critical, critical injuries.

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As I assessed him, I realized that there was nothing

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that could be done for him,

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and like so many other cases,[br]he looked me in the eye

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and asked that question: "Am I going to die?"

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In that moment, I decided to do something different.

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I decided to tell him the truth.

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I decided to tell him that he was going to die

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and that there was nothing I could do for him.

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His reaction shocked me to this day.

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He simply laid back and had a look

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of acceptance on his face.

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He was not met with that terror or fear

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that I thought he would be.

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He simply laid there, and as I looked into his eyes,

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I saw inner peace and acceptance.

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From that moment forward, I decided

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it was not my place to comfort the dying with my lies.

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Having responded to many cases since then

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where patients were in their last moments

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and there was nothing I could do for them,

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in almost every case,

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they have all had the same reaction to the truth,

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of inner peace and acceptance.

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In fact, there are three patterns

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I have observed in all these cases.

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The first pattern always kind of shocked me.

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Regardless of religious belief or cultural background,

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there's a need for forgiveness.

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Whether they call it sin

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or they simply say they have a regret,

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their guilt is universal.

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I had once cared for an elderly gentleman

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who was having a massive heart attack.

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As I prepared myself and my equipment

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for his imminent cardiac arrest,

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I began to tell the patient of his imminent demise.

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He already knew by my tone[br]of voice and body language.

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As I placed the defibrillator pads on his chest,

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prepping for what was going to happen,

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he looked me in the eye and said,

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"I wish I had spent more time with[br]my children and grandchildren

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instead of being selfish with my time."

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Faced with imminent death,

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all he wanted was forgiveness.

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The second pattern I observe

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is the need for remembrance.

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Whether it was to be remembered in my thoughts

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or their loved ones, they needed to feel

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that they would be living on.

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There's a need for immortality

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within the hearts and thoughts of their loved ones,

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myself, my crew, or anyone around.

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Countless times, I have a patient look me in the eyes

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and say, "Will you remember me?"

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The final pattern I observe

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always touched me the deepest, to the soul.

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The dying need to know that their life had meaning.

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They need to know that they did not waste their life

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on meaningless tasks.

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This came to me very, very early in my career.

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I had responded to a call.

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There was a female in her late 50s

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severely pinned within a vehicle.

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She had been t-boned at a high rate of speed,

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critical, critical condition.

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As the fire department worked[br]to remove her from the car,

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I climbed in to begin to render care.

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As we talked, she had said to me,

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"There was so much more[br]I wanted to do with my life."

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She had felt she had not left her mark on this earth.

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As we talked further, it would turn out

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that she was a mother of two adopted children

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who were both on their way to medical school.

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Because of her, two children

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had a chance they never would have had otherwise

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and would go on to save lives in the medical field

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as medical doctors.

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They would end up taking 45 minutes

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to free her from vehicle.

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However, she perished prior to freeing her.

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I believed what you saw in the movies:

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when you're in those last moments

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that it's strictly terror, fear.

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I have come to realize,[br]regardless of the circumstance,

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it's generally met with peace and acceptance,

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that it's the littlest thing, the littlest moments,

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the littlest things you brought into the world

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that gives you peace in those final moments.

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Thank you.

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(Applause)