The number was typed into my phone, thumb hovering over iPhone call button icon. For at least a minute I was frozen. It was my patient’s daughter. Three in the morning. This is a total DSP, I thought. Parlance for “day shift problem”. Calling families is a total DSP but if someone dies or is actively trying to die you have to do it. Hell. But there was little optimism he’d make it through the night, so. I inhaled deeply and exhaled slowly. Pressed the button. I hoped she wouldn’t answer. Rang a few times and I had that thank god feeling until someone said hello. Shit. I told her I was doctor so and so, a resident at the hospital, working in the intensive care unit. She asked about her father. I had to tell her with muted emotion that he wasn’t going to make it much longer. Do you want us to continue complete resuscitation measures, i asked.
I just, I just need a minute, she said.
She came back. Explained to me how they thought he was doing better, his kidneys were improving and the numbers indicated his infection was clearing up. He was doing better, she said, voice choked up from the burst of emotion one feels when they hear that someone they’ve known their whole life, someone who made them who they are, is for all measures, gone. And will never come back.
I got angry. How the hell did anyone paint a picture that he was doing better. Why give this woman and her family that hope. I professionally sucked all of that hope of out them. All I could think to say was I’m sorry. What can you say: I’m sorry.
Whisper in his ear, she pleaded. Please just tell him. Tell him it’s the fourth quarter. It’s the fourth quarter, you just have to keep going. He loved football. That was his favorite saying, she cried. Just tell him that. Tell him it’s the fourth quarter and he can’t give up now. Tell him to keep fighting – it’s the fourth quarter.
I removed the phone from my face and flexed my abdomen and tensed up to stop this flood of feelings. Fuck, stop. I don’t want to do this. I don’t want to tell you this. Anyone in medicine knows when the point of no return has been reached, and – he’s there. I’m sorry. I’m so impossibly sorry. This patient on my list is your dad and you love him and I’m so, so fucking sorry. There is no alternative. Stop humanizing this. Stop making this so much harder for me. I looked through the glass wall to his room and looked at the man, tube in his throat, machine mechanically pushing air into his lungs, nurses huddled around his body overriding the “max dose” setting on the drugs that were keeping his heart pumping, on three pressors and maxed vent settings and dying. I’m so sorry. I’m sorry. I’m sorry. God.
Stay with me on the phone, she said. Talk to me.
Like a movie flashback I remembered something I hadn’t thought about in ten years. Why. I remembered first time I wanted to be a doctor. The first time I told myself I want to be exactly where I am right now.
My childhood, I had it good, make no mistake about that. My father was a surgeon. But my parents divorced when I was young. My father lived far away. I was a problematic child. My mother, a mother of four boys, four wild and reckless boys, was tasked with raising us essentially alone. Her parents, my grandparents, gave up their retirement beach condo and moved back to raise us while my mom worked. My grandmother was my second mother growing up. She was the one that made sure I did my homework. Ate my vegetables. Old school Italian woman who would whip my ass with the spatula if I talked back. But she had a sense of humor and love that she carried with her. She did everything out of pure love to help her daughter, my mother. Gave up her last years to raise some ungrateful kids.
One afternoon I was in the basement. Doing kid things like playing video games on my PS2 or GameCube or whatever at the time. Phone rang – landline like we used to have. I picked up and it wasn’t for me. I stayed quiet and eavesdropped. My grandfather answered at our home. It was the sherif. She had been in a car accident. She was taken to the hospital. Critical condition. At my adolescent age I tried to surmise what this all meant and I didnt know but I understood the tone. The feeling.
Later that night my aunt sat me down and explained everything to me because my mom couldn’t. Grandma was on a breathing machine and they had some hope that she would recover and she told me to pray so every night I lied in my little childhood twin bed and locked my fingers in the prayer formation and prayed to god that my grandma would get better. Through the vents at night I could hear my mom crying. Smell cigarette smoke. For nearly thirty days. My birthday was three days before this had all happened. She had given me card, with a little message of well wishes and love and above all — a plea to make my mom proud someday — signed:
I remember opening the card on my birthday and not reading a single word that was written and seeing a $50 bill that I shoved into my pocket before discarding the letter. It was the last moment I spent with her and I hated myself for it. I’d go in the bathroom and run the shower for an hour just so I could cry without inhibition where no one would hear me. I read it every night she was in the hospital on the ventilator. All thirty days. Until I had heard my mom cry so much that one night I prayed to god that he would take her and bring my mom some closure. I dreamt of my grandma that night and she said: it’s okay, I love you, it’s okay. My 14 year-old brain trying to make sense of it all.
The next day the decision was made to pull the plug. I still vividly remember it all. My mom took me and my brothers to the hospital to see her. Cords and tubes spilling out from her body. It wasn’t my grandma anymore. She was such a beautiful and prideful woman. Even at a young age I knew: this is not life. Later that day, she was gone.
I cried and cried and cried clutching that birthday card. Hating myself for not appreciating her for all she’d done for me and all the love she’d given. For not telling her how much she meant to me. So I told myself I had to become a doctor. Not because I had any delusional ideas of saving people that couldn’t be saved. But I had to become a doctor for that moment. Where you had to break the news. This moment. Now. This is what you were born to do.
I’m sorry. I’m here with you, I said, as a tear rolled down my cheek. Why don’t you tell me your favorite stories about him.