Another Day, Another Death: A Day in the Life of a Critical Care Doctor

By Sarah Shapiro

Winter 2020 Kaplan Award Winner

The hallway was still, the murmur of medical machines the only sound to be heard.  I followed my father through the intensive care unit, feet squeaking on the freshly scrubbed floors with each step.  Rooms lined the hallway, patients tucked in the curtain’s shadows.  Everything felt foreign and sterile.  It had been years since I had been in any part of a hospital besides the check-up area.

We gathered around the intensive care team, a group of medical professionals wearing the autonomous uniform of blue scrubs and white coats.  I felt out of place in my sweater and leggings.  I buttoned up the lab coat my father had given me, a desperate attempt to fit in.  My father was the staff physician and assistant professor of medicine at Hennepin County Medical Center.  Quite the prestigious title.  Upon my request, he had brought me to shadow him for a day.

When I asked what shadowing entailed, he explained I would watch him do rounds.  In human terms, this meant observing the daily check-in on patients in critical condition in the ICU.  He introduced me to his team, a mixture of fellows, residents, critical care nurses, respiratory therapists, and pharmacists.

“Do you want to go into medicine?” the fellow asked, logically assuming these were my aspirations.

“No, I’m just here for fun.” I remarked, not sure what to say.  Suddenly, it felt sadistic to spend my day observing the terminally ill.  For fun.

We gathered outside the first patient’s room, and the resident gave background information to the team, in medical speak I could not follow.

“What would be your method of treatment?” my father asked.

The resident elaborated, his words sounding like Pig Latin.  My father listened intently.  He stood frozen, awaiting my father’s opinion in hopes of approval.  He gave his corrections, with a confidence that only comes with years of experience.  All eyes stayed glued my father, the team infatuated with his knowledge.

We entered the room, bare except for a bed, various medical machines, and a few pieces of furniture.  An elderly woman lay there, so small and shriveled she barely made a crease in the bed.  She had a blank expression on her face, her chest rising slowly as if it took her whole effort just to breathe.  Which was ironic, considering the ventilator was breathing for her.

My father slowly approached her.

“Hi, my name is Robert.  I’m your doctor at Hennepin County.  Can you hear me?” He firmly shouted.

The woman barely nodded.  My father checked up on her ventilator settings.  The fragility of her state made me feel queasy.  It seemed doubtful she would make it out.  I was glad to leave.

The pharmacist, a small woman in her mid 30’s, was the only one who seemed to notice my presence, asking generic questions about my life.  While I often found these questions monotonous, in this instance I was grateful.  I found myself looking at the clock, counting down the minutes until it was time to leave.  Reaffirming my instinct that a career in medicine was not for me.

Most of the patients we visited were elderly, the kind you would expect to see hooked up to a breathing machine.  As we walked to the next room, the pharmacist pulled me aside.

“Did you father tell you about this next patient” she asked.

I shook my head.

“It’s really sad.  This college age boy, he overdosed on drugs a few days ago.  His roommates found him and brought him in, but it’s too late.  He went into cardiac arrest, braindead.  His whole family’s been here for days, but they don’t know yet.  Your father has to tell them today.  Absolutely Tragic.”

Before I had time to process the gravity of what she said, we entered the room.

The boy was hooked up to the ventilator, looking almost asleep.  He was handsome in a boyish way.  He seemed so normal, like he could be any one of my friends at school.  This caught me off guard.  When I thought of drug-users, my mind flashed with stereotypical images of raggedy men on the streets, tattered clothes and cardboard boxes.

To the side of his bed stood a few relatives.  Mom, dad, sister, and a few more I could not identify.  His sister wrapped her arms around her father’s shoulders, sitting together on the bench.  His mother stood up, arms clutching her waist, as if trying to comfort herself.  They all had the same blank expression, unable to focus their gaze.  The tension was almost unbearable.

My father approached the family and began to talk.  He spoke calmly and softly, so much so that I could barely hear what was said.

“Your son has experienced a neurologic death… although his heart’s still beating, he is classified as brain dead… we can give you a few hours to say bye, but then we will turn of the machine… the body will go to the morgue and you will have to make arrangements from there…”

There was an abrupt silence.  Then, his mother collapsed into tears, her body vibrating with each sob.  His sister put her head into his father’s shoulders.  A man, who I presumed was an uncle, abruptly left the room.  I felt strangely bothered by my own presence.  I had just witnessed a family realize their precious boy, his whole life ahead of him, was gone.  What right did I have to watch such an intimate moment?

As we moved onto the next patient, no one seemed phased by what had just occurred.  I imagined they had learned to hold it in.  There was no other way to bare it.

Surprisingly, this was a relatively smooth encounter.  My father had told stories in which security had to be called on families, who refused to accept their loved one was dead.  They would obstruct the doctors from unhooking patients from ventilators, becoming hostile and violent.

But I could not shake it.  I imagined the boy’s first day of kindergarten, his mom hugging him tight before she sent him off to class.  The look of joy on his father’s face, the first time his son learned to ride a bike.  The boy and his sister laughing as they played on the swing set in their backyard.

The boy limp on the couch, his roommates arguing over the risks of calling the police.  The call from the hospital, a thud as the phone drops to the floor when his mother hears the news.

I remember all those years seeing my dad come home from work.  Grabbing fistfuls of pretzels from the cupboard, starved after hours of being unable to eat.  Muffled voices from the kitchen as he talked to my mother about his day.  My father often seemed sad to me.  I realized it must be strange for him, shifting from tragedy to mundane life in a matter of hours.  The death of a young boy was in his hands.  Because of me and my sister, this hit close to home.  My admiration for him deepened.

My thoughts were interrupted by the sharp buzz of my phone.  A text from friend Julia, complaining about something her boyfriend had said.  And just like that, the boy was erased from my mind.  Similar to my father, I needed him to be.  I was once again absorbed into the intricacies of my own life.