His Last Birthday

“Happy birthday, buddy”, I murmur as I place my hand on his arm. I wonder if he can hear me through my CAPR. The fan is so damn loud. I stare at his limp, paralyzed, hypoxic body and think: “Maybe this one will make it. Maybe he’ll be one the of the lucky ones.” I watch his body slowly deteriorate throughout the day. We add one medication after another; consider every last option. I question every lab; ask myself over and over again if I have the next bag of this or that medication ordered. Has someone talked to his significant other today? She brings in a basket of goodies. “Happy birthday, ****.” reads the card along with “thanks for your work” and “please save some for noc.”

I wonder if he’ll make it that long.

I read the notes from his admission. He has children. He was scared about being intubated. He was struggling to breathe. I wonder what the last thing he heard was before we sedated and paralyzed him. I wonder what his last thought was. I hope it was something pleasant.

I sink into bed exhausted; glad to be done; glad he made it through my shift; glad to know someone I admire, trust and respect is now in charge of his care.

I allow myself to feel a tiny bit of hope. Maybe. MAYbe he’ll see his kids again.

I wake up to a text from my coworker. “Our fellow coded and died this morning.”

I burst into tears.

No matter how clearly I can see the bigger picture, no matter how many times I tell myself that what we see in the ICU is the minority, no matter how angry or “over it” I feel, or how much I desperately want to stop caring, there will always be those tears.

Happy birthday, buddy. I’m sorry it was your last.