Working in the ICU, I now know what hell feels like


I walk up to the ICU. Ecstatic.

I just placed a subclavian line, a chest tube, and performed a bronchoscopy on my patient. Intern year is going well, and today is a great day.

For me.

I have been learning so much, been trusted to do even more, and been a part of gratifying experiences. Successes. Life-changing procedures. Things that still make me sit in awe that we can transform the human body, alter physiology, and still have good outcomes. It is a good day.

For me.

As I walk into the ICU, I see an old man — likely well into his 70s, judging by his pronounced wrinkles and magnetic gait — with tears in his eyes, sucking in air, walking as fast as he can to the exit, silently sobbing.

I stare. But I can offer nothing.

As I approach my patient’s room, I am greeted by the ICU attending, who curtly tells me, “she suffered an infarct of her right MCA. It’s unsurvivable. Her family just withdrew care.”

And I knew.

It was a good day. Only for me.

I immediately knew that he was the family.

I immediately knew that it was his decision.

And I immediately knew that he ran out of the unit to cry his most horrifically provoked cry, knowing that he will never get to say goodbye to his wife again.

And just then I realized what hell feels like.

To know that I will never know her circa 1965 when she dressed up to attend a ball, or how he asked her to marry him, or how it felt to be a part of their first family picture, or how it felt to buy their first house together, or how they ended every single day with a good night kiss.

I will never know.

But what I do know is how his face was contorted into a true expression of grief. And how he held his breath to keep from crying. And how he ran out of the ICU so that we wouldn’t hear his wails of fear, anger, and grief.

I will never know how they were together. And I will never be a part of what they were. I will never know how they loved. And I will never be a part of their beginning.

But I was a part of how they end.

That’s what hell feels like.

Edwin Acevedo, Jr. is a general surgery resident.

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