Republished at: https://www.kevinmd.com/blog/2019/04/a-patients-last-24-hours.html

There are those 25 minutes before my work day begins that I either drive in silence, or blare the radio and jam out to pop hits priming myself for the unexpected hours ahead. When the music is loud and the tempo is upbeat, it transports me back to being 21 on a summer day in Chicago, before kids and bills, headed nowhere too important, definitely not too fast, stuck in traffic on Lake Shore Drive. But lately, I’ve trended more towards driving in silence. Calmed by the gentle hum of the engine, feeling the gentle pull of the turns in the road, letting my mind settle. And lately, my mind has been on you.

My heart settles into a dull ache. It pulls me in and hollows me out. I feel unjustified in feeling this way. These are not my feelings to feel. These are not my emotions to own and declare. There are people more deserving of telling this story. It is not me. But here I am. These emotions clinging onto me for the past 5 weeks now, and I don’t want it just to be in my mind. I don’t want this hollowness in my chest to go unidentified. It means too much. So, I’m going to talk about you.

I met you on a busy night in the emergency department. You were short of breath, you were sweaty, your heart rate was going too fast. I thought within seconds of meeting you, “He is sick.”

When emergency medicine providers say someone is sick, it doesn’t mean the usual sick.  We do not throw around the word “sick” haphazardly.  It does not mean you have the sniffles, or a bad cough, or fever, or appendicitis, or a broken leg. When we say “sick”, we are on high alert. Our heads turn.  Our focus shifts from everyone else in the emergency department to you. You are the one that needs us most. We will take care of everyone else, but you have taken priority over everything else that must be done. Bluntly put, when we say “sick”, we realize–perhaps before you do–that you are struggling for your life.  We are worried that you may get worse and die.

Everything had happened so suddenly, your wife told me. You had seemed fine. Maybe a little fever. Maybe a bit of body aches. Then tonight, you were suddenly short of breath. Sweating. Feeling your heart beat out of your chest.   You have no idea what suddenly changed. I don’t want to get into the medical specifics. Though I replay them over and over in my mind. I pour over your chart again and again. What more could I have done? I’ve talked to my closest colleagues. I’ve lay in bed at night and replayed everything.

I remember exactly how you looked when I walked in the room. I remember your wife sitting there on the edge of her seat.   I remember you said you have three kids. Two boys and a girl. I remember how old they are. I remember the name of your youngest. I remember the puzzled look your wife gave me, “What is going on?” I remember explaining to the both of you what was happening. How infection was taking over your body, taking over your organs, shutting down your body. You asked me how long you would be in the emergency department. I explained you needed to be admitted to the intensive care unit. You both were a bit puzzled. How could a healthy 43-year-old become sick so fast? I explained that I was worried about you.

I don’t worry about a lot in the emergency department. I can handle it. I can fix it. But you. I was worried about. I did everything my training had taught me to do.  You were getting better. I felt slight hope that maybe things would turn around. You were admitted to the intensive care unit.

The next day, I checked on your chart when I got to work. You had died.

You have a beautiful wife. You have three amazing kids. You are the nicest of people. You are hard working.

You are no longer with us.

My heart aches. My heart aches, but when it aches, it is an unworthy ache. Because the heart ache of those that love you, those that were your life: your wife, your children, your parents, your siblings, your nieces and nephews, those are the ones that are truly hurting. And this makes my heart ache more. I wish you were alive. They wish so more than my words can do justice.

I did everything I knew how to.  But it wasn’t enough to save your life.  I wish I could have done more. I am so, so sorry.

I was maybe one of the final ten people you met in your life. For you, I was only part of those last 24 hours. For me, you will be in my heart a lifetime. I can’t even say this without grimacing, because what you mean to me doesn’t even compare to those that love you most. But I just want you to know, you have affected me. You will stay with me. You will live on in every one you touched along the way. Even in your last 24 hours of life.