The Brevity of Goodbye

All night, a young man lies in the emergency room. All night, I watch his monitor. It beeps intrusively until I silence it. But he is quiet. His friend stands at the bedside, holding his hand. I offer a chair but he tells me he cannot sit. People stream in and out of the rooms around them – vomiting, cursing, moaning, laughing. I pour fluids into him, hoping that I can reverse this. He is too young. But I watch his monitor, hour by hour, 2AM, 3AM, 4AM, until I imagine the morning light pounding against the walls of this concrete jungle. His numbers are more stubborn than I am. They will not change.

It should not have to be this way.
But it is.
He should not be in septic shock.
But he is.
He and his friend watch my face as I watch the numbers.
They will not change.

And so, as morning crests over the horizon, blocked by the concrete that surrounds us, I prepare. The chaplain comes. As I click the blade into place, inflate the cuff, check the light, his friend asks me if we can say a prayer first. Of course we can, I say. If I cannot help him then maybe a prayer will, I think. The chaplain grasps their hands and bows her head. I look away, tune them out. I need to concentrate. I cannot get swept up in this, I remind myself. Not today.

As his friend leaves, I dress in my gown and mask – an alien even to myself. I slide latex gloves over my fingers – a reminder that it is time. Suction, blade, tube. Push the etomidate, I say loudly to hide any lingering emotions in the crowd. Push the succ. Faces surround me. I hold his head in my hands – feel his strong jaw line at the base of my fingers. I give him oxygen, to the rhythm of my breathing. Slower, I remind myself. Slower than this.

I watch his muscles twitch. I watch his eyelids flicker. I breathe in once more. And then I begin. I grasp that curved blade, widen his jaw, push the tongue aside. I do not take my eyes off his vocal cords. These cords which must have said so many things over the last thirty years – but not nearly enough. These cords which may never vibrate, laugh, or whisper again. I slip the tube gently between them.

I wonder if his lips will ever be without a tube again. I wonder if this is the wrong decision – to deprive him of his words at this moment. An urge swells up in me to take the tube out, to let him say one last – something. Goodbye, perhaps. But what good will it do? I want to save him. But I cannot. All I can do is place that tube, a long narrow strip streaming oxygen into his lungs. All I can do is give him a machine to breathe for him as his body fails. All I can do is hope that he pulls through this, against the odds.

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One Response to The Brevity of Goodbye

  1. RD Carter says:

    Heartbreaking.

    No physician ever gets to show this side. I will pass this on to others.

    Thank you.

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