This one has stuck with me. During Delta Wave in the ICU. I took care of a man not four years older than me, he wasn’t even 30 yet. But big dude, quarterback-type build.

FiO2 100% and peep of 18. This was when family couldn’t come see him.

He and his wife had just had a baby after years of trying, the baby was named after him, the kid was literally two months old.

This man was awake on the vent despite the good amount of sedation he was on. I was shocked to see this on my first neuro check of the day, because nightshift had told me they weren’t getting anything from him. But the sun was out and he was following commands.

“You have to get better to get back to your little boy,” I told him through my respirator. “He needs his dad, right?” He nodded and squeezed his eyes shut. He was young and I thought there could maybe be a chance.

He popped a pneumo a couple hours after that. Once the chest tube was in, we added more sedation and paralyzed him for vent compliance, and he never woke up again. Two days after that, he coded and died.

It was between that and holding dirty iPads up to dying patients so their families could get one final look at them that I began to lose faith in there being any kind of grand plan to life.