Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

I fear that I’m not doing the right thing and I do it anyway

Lauren Rissman, MD
Physician
February 22, 2021
Share
Tweet
Share

I fear that I’m not doing the right thing. You’re trusting me with your life. I hear you telling me that you don’t want me to do what I am about to do. I see it in your eyes, the resentment as you look toward your family. And hatred for me, your physician.

You trust me to care for you as you enter the unit. I tell you I will. You say, “Yes” when I ask if I could listen to your chest, the stethoscope linking us together. You say, “Yes” when I ask if I could make you more comfortable, holding my hand as you gasped for air. You, nearly an adult, confide in me that you don’t want a breathing tube. Because your parents ask me to place it, I plan to do so—against your wishes and my ethics. The levels of carbon dioxide rising in your body is intoxicating and you become tired and then incoherent. Medically, you no longer have the capacity to tell me you don’t want something to be done. But I cannot unhear what you said to me, loud and clear. You rest your eyes, and then wake up minutes later agitated, yelling, gasping, and then falling back to sleep again.

Your parents aren’t ready to let you go, even if you are ready yourself. I try to reason with them, to advocate for you. I try to get your parents to hear me when I say that we can’t cure your cancer. They don’t want to hear me or possibly can’t with all the commotion in the room and in their heads. I try to tell them that a breathing tube would only prolong your life. I tell them that they may not ever hear your voice again if I place it. This gives them pause, but only briefly. I advocate for medications that would allow you to breathe more easily and struggle less. I encourage your parents to lie in bed beside you as you pass away in peace. I know that’s what you want.

I told you I would take care of you, and I fear I am not. Your plea to die is humbling. I feel inadequate that I cannot respect your wishes. I feel inadequate that your parents want more and I, who have been entrusted with your care, have nothing more to offer.  With all the advances in technologies and medicines, we are still not limitless. I stand beside you powerless against life’s natural course, despite every toxin and tube placed to prevent it from happening. In this moment, we all lose.

Your parents kiss you on your head as they leave the room and I prepare to place the breathing tube. Nurses are bringing medications to your bedside to ease your suffering. Respiratory therapists are preparing the ventilator and tubes.  Monitors are silenced behind you.  Like before, you jolt upright in bed, yelling that you don’t want a breathing tube. I am next to you, holding your hand, speaking quietly, telling you to rest. Your nurse administers a medication for the anxiety. As your nerves settle, I slide behind your bed against the wall preparing myself to place a tube in your body against your wishes.

I stand behind you, our eyes locked together. I can see your eyebrows furrow beneath the mask I am pressing against your face, my fingers lifting your chin closer towards mine in an abnormal embrace. You hate me, and I can’t blame you. I order more medications for your suffering.  Finally, your eyes close and my own suffering eases for just a moment.

I fear that I’m not doing the right thing and I do it anyway.

Lauren Rissman is a pediatric critical care fellow.

Image credit: Shutterstock.com

Prev

An open letter to the medical community at large regarding the termination of Dr. Princess Dennar

February 22, 2021 Kevin 1
…
Next

Overcome COVID vaccine hesitancy and boost vaccine confidence: How you can help

February 22, 2021 Kevin 3
…

Tagged as: Critical Care, Pediatrics

Post navigation

< Previous Post
An open letter to the medical community at large regarding the termination of Dr. Princess Dennar
Next Post >
Overcome COVID vaccine hesitancy and boost vaccine confidence: How you can help

ADVERTISEMENT

More by Lauren Rissman, MD

  • Don’t become a doctor?

    Lauren Rissman, MD

Related Posts

  • A physician’s addiction to social media

    Amanda Xi, MD
  • The miscalculated fear of an opioid crisis in Haiti

    Kenny Moise, MD
  • In the face of uncertainty, choose hope over fear

    Shreya Kumar
  • A medical student’s biggest fear

    Ariana Trautmann
  • Don’t let fear harm your health

    Michele Luckenbaugh
  • I’m sorry that we couldn’t save you

    Evan Schauer

More in Physician

  • Inside the heart of internal medicine: Why we stay

    Ryan Nadelson, MD
  • The quiet grief behind hospital walls

    Aaron Grubner, MD
  • a desk with keyboard and ipad with the kevinmd logo

    How to advance workforce development through research mentorship and evidence-based management

    Olumuyiwa Bamgbade, MD
  • The truth about perfection and identity in health care

    Ryan Nadelson, MD
  • Civil discourse as a leadership competency: the case for curiosity in medicine

    All Levels Leadership
  • When a medical office sublease turns into a legal nightmare

    Ralph Messo, DO
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Inside the heart of internal medicine: Why we stay

      Ryan Nadelson, MD | Physician
    • The quiet grief behind hospital walls

      Aaron Grubner, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • Bundled payments in Medicare: Will fixed pricing reshape surgery costs?

      AMA Committee on Economics and Quality in Medicine, Medical Student Section | Policy
    • How Project ECHO is fighting physician isolation and transforming medical education [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why clinical research is a powerful path for unmatched IMGs

      Dr. Khutaija Noor | Education

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Inside the heart of internal medicine: Why we stay

      Ryan Nadelson, MD | Physician
    • The quiet grief behind hospital walls

      Aaron Grubner, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • Bundled payments in Medicare: Will fixed pricing reshape surgery costs?

      AMA Committee on Economics and Quality in Medicine, Medical Student Section | Policy
    • How Project ECHO is fighting physician isolation and transforming medical education [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why clinical research is a powerful path for unmatched IMGs

      Dr. Khutaija Noor | Education

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

I fear that I’m not doing the right thing and I do it anyway
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...