This article has been deidentified to protect the anonymity and confidentiality of the patient in the story. Any matches in names or circumstances to other patients are entirely coincidental.
His face was now pale. The body that had labored for each breath lay still beneath the thin hospital blanket.
I placed my stethoscope gently on his chest. Silence. I moved it higher, beneath the clavicles. Still nothing. His eyes stared blankly at the ceiling. I instilled a few drops of saline. No response. His water bottle rested on the bedside table, the bendy straw still angled toward where his mouth had been.
I pronounced him dead at 11:32 p.m.
It had been just over 24 hours since I first met him.
The night before, he had arrived in the Intensive Care Unit (ICU) with acute respiratory failure in the setting of stage 4 lung cancer and recurrent pneumonia. Not long into my shift, his nurse paged me. She was having trouble maintaining his peripheral intravenous (IV) access and asked if I could try using ultrasound.
When I entered the room, he was propped up in bed, face drawn, quietly gasping on high-flow nasal cannula. Yet he smiled at the sight of me wheeling in the machine.
He watched me with calm amusement as I fumbled with the probe, squeezing his arm in search of a viable vein. I kept apologizing—partly for his discomfort, partly for my inexperience.
“You can do it, doctor,” he said, his voice weak but cheerful.
Now, standing in the doorway, I was calling his mother to tell her that her son had passed.
There was a long pause. Then a faint sob spilled through the phone. I felt a choke rise in my throat.
I realized I was crying, too.
In the ICU, we often care for dying patients. Goals-of-care conversations, palliative extubations and death pronouncements become part of our responsibilities. Over time, we learn to set our emotions aside and carry on. So I was surprised by how deeply this one struck me.
I had known him for barely a day in his 50-some years of life.
Maybe it was the gratitude I felt for the kindness he offered an intern, even amid his hunger for air. Or the ache stirred by the bruises on his arms—each one a testament to his longing to live. Perhaps woven into it all was a sense of relief that the long cycle of chemotherapy, readmissions and dashed hopes had finally come to an end.
Then, part of me grieved for an elderly mother who had to learn of her son’s death through the distance of a phone call. Bedbound in a distant nursing home, she could not be at his side.
His mother asked what had caused him to die. I told her his lungs had failed, worn down by cancer and infection.
“Was he in pain?”
I reassured her that hours earlier, we had transitioned him to comfort care according to his wishes. We had started drips to ease his breathing.
She wondered what came next. I explained his body would be transferred to the morgue and someone would call her to arrange a funeral home.
She thanked me.
After the call ended, I stood there for a while, catching a final glimpse of him, now wrapped in peace.
Sometimes, even the briefest encounters can leave a lasting imprint. In medicine—and in life—connection often blooms in the most fleeting and fragile moments.
And sometimes, that is enough.
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