The illusion of immunity

The story we recognizeThere is a particular kind of story that circulates quietly among physicians. It is not the dramatic saves or the rare diagnoses in clinical that make for conference presentations, but the ones that occur when we least expect it. We’ve all experienced them and they all begin the same way:“I was there when it happened.”A physician friend recently told me about one such experience on a recent scuba diving excursion. It had just begun and her group, having completed all the safety checks had begun their descent into the Caribbean waters. They admired a sea turtle before reaching their full depth and were then asked to wait for a moment, anxious in quiet anticipation of diving deeper. Suddenly, underwater sirens were blasting, they were given the signal to surface immediately, and when my friend reached the surface, she saw that a woman’s limp body was being hoisted up onto the boat.There was no hesitation. The woman’s wet suit and swimsuit was cut away and CPR began almost immediately. The boat was well equipped for this emergency, she said: Compressions, breaths, the coordinated rhythm of people who understood what needed to be done, even as the situation unfolded around them.The medical team worked on her for 25 minutes as the boat rushed back toward shore. It was long enough for the urgency of the situation to settle into something steadier. Long enough for the moment between life and death to narrow down to the weight of hands, the recoil of the chest, the two-minute cycles of an AED, continuous assessment of whether anything was changing. The shoreline remained in the distance, approaching too slowly to matter.When she was back to shore, she called me and told me about it without drama, without visible distress. And then she said, almost as an afterthought:“I think I’m immune to death.”The statement lingered, not because it was shocking or insensitive, but because it felt familiar in a way that was difficult to name.The body that moves firstI have felt something like it before. A few years ago, I was at a resort pool when a child was pulled from the water unconscious. One moment there was the diffuse ease of a vacation afternoon—the brightness of sun on water, the joy of my children playing in the pool—and the next, a small boy laying on the concrete, still in a way that was immediately, unmistakably wrong.There was no pause. Only action. My body moved before the thought had fully formed. Running across the hot concrete in a bikini. My fingers searching for a pulse and then hands placed, compressions started, and the sequence unfolding with a familiarity that felt almost out of place in that setting. There is a strange dissonance in bringing the machinery of medicine into a space meant for rest, in feeling yourself shift so quickly from presence to performance.In those moments, everything else falls away. The noise, the people, the context, it all recedes until there is only the task. The “Staying Alive” rhythm takes over. You count without thinking. You adjust without hesitation. You continue for as long as you need to.And then, eventually, it ends.It is not the moment itself I remember the most, but how and what I felt in the days that followed. I expected relief, or at least a return to whatever the day had been before. Instead, there was a distance from reality. The warm afternoon flattened against itself. Conversations at the dinner tables were blurred at the edges. I could participate in activities with my family, but I could not fully arrive. It was as though part of me had remained at the scene of the action, still caught in the rhythm of the trauma that my body had not yet released.At the time, I might have called that composure. Or professionalism. It did not feel like distress in any obvious way. It felt like nothing. And I think that is where the idea of immunity begins.What we learn to doIn medicine, we are exposed to death in a way that most people are not. Not just once, not as a singular event, but repeatedly, across different settings and contexts. We meet it early, and we meet it often. Over time, we learn how to function in its presence. We learn how to move toward it rather than away, how to place our hands where others hesitate, how to begin without waiting for the full weight of the moment to register.The first encounter often feels loud with adrenaline, difficult to contain. But repetition changes something in how we encounter death and dying. The edges soften and the sequence becomes familiar. We begin to trust our hands, to rely on the structure of what we have been taught. There is no space, in those moments, to be overwhelmed. The work requires clarity, and so we find a way to create it. We work in teams. We narrow our attention. We focus on what can be done. We let everything else recede just enough that we can continue.From the outside, this can look like detachment. And if often feels that way from the inside as well. We become able to stand in the presence of death without visibly breaking, to act and speak with a steadiness that suggests a proper distance from what is unfolding.But this is not indifference. It is adaptation.What doesn’t go awayIt is not unreasonable, then, to wonder whether something in us has changed more fundamentally; to question whether repeated exposure to death has made us less sensitive to it.But the experience is more complicated than that. We do not develop an immunity to the effects of death, but a kind of protection against its immediacy. We learn how to function within it, how to act without being overtaken in the moment. The emotional response is not absent so much as it is deferred. And what is deferred does not disappear.It shows up later, or differently, or in ways that are easy to miss. In the difficulty concentrating after an event that, at the time, felt routine. In the subtle inability to settle back into rest. In the quiet sense of distance that lingers longer than expected. In the aftermath, the body processes what the moment could not hold.For those outside of medicine, encounters with death are often singular and disruptive, leaving a clear imprint and demanding immediate care and processing. For physicians, they accumulate. Each one contained just enough to allow us to move forward but not always integrated in a way that allows it to fully resolve. We become very good at staying. At keeping our hands steady. At continuing the rhythm of our lives long after others might step back.What we call immunityPerhaps over time we begin to mistake this ability for containment as immunity.After experiencing death in unexpected ways, we may ask ourselves: “Am I immune to death?” However, I don’t think we ever become immune to death. I think we know how to stand beside it. We know how to act within it, and how to continue when continuation is required. Yet somewhere beneath that practiced response, something remains unresolved, unacknowledged, and quietly present. It is not enough to stop us, but enough to shape us. Perhaps the question we should be asking is not whether we have become immune, but what happens to everything we have learned not to feel in the moment—and whether we have made any space, in the lives we return to, to feel it at all.Dr. Ginevra Mills is a reproductive endocrinologist and infertility specialist based in Victoria.

The illusion of immunity

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