I became a respiratory therapist at 28, after years of trying to get into nursing school. It wasn’t until a friend, an RT at my city’s only level one trauma center, said, “You don’t want to be a nurse. You want to be an RT,” that something clicked. He let me shadow for a shift in the medical cardiac ICU, and I fell in love with the work instantly.

Watching him move from room to room, supporting patients, calming families, saving lives: It felt like something sacred. And for a long time, it was.

There is so much I love about Harborview. It’s rare to find a building filled with all different kinds of people, from all different walks of life, who are just there to help, in whatever way they can. I’ve worked alongside some of the most brilliant, big-hearted humans I’ve ever known. Together we’ve witnessed miracles, and I had the privilege to have seen medicine at its finest: creative, collaborative, life-saving.

But I’ve also seen what few outside the bedside will ever fully understand. I have seen tragedy and loss on the grandest scale there is, but I have also seen love. Real, unwavering, committed love, and I had the pleasure of witnessing it every day, if I took the time to look.

As a respiratory therapist, we are involved in nearly every death in the hospital. Our workflows make it so we don’t often get to know patients or families deeply, like nurses. We are asked, or forced, to move quickly, helping where we can, adjusting vents, suctioning airways, comforting the dying, and then quickly moving on to the next.

Some days were manageable. Some were even beautiful. But other days stayed with me.

I frequently kept patients alive long after it felt ethical. I witnessed brain death declarations that felt rushed and wrong. I provided care that looked like treatment but felt like prolonging suffering. I watched decisions made from above that didn’t feel rooted in humanity. I watched colleagues troubleshoot “machines” and forget to look at the human being it was attached to.

Over time, the work started taking more than it gave. I began to carry not just fatigue, but moral injury: That deep, quiet ache that builds when you know something isn’t right but feel powerless to change it. The kind that doesn’t go away with sleep or vacation. The kind that lives in your body.

And for respiratory therapists, it often goes unseen.

We are expected to endure everything quietly. We are frequently left out of decision-making, but always present when it falls apart. We go home shaking. We go home empty. We cry in bathrooms. We avoid telling our families what really happened that day because we don’t want to burden them. After a while, no one asks… and we stop talking about it.

This isn’t just a problem at my hospital. This is health care. This is a system that says “keep going” no matter the cost. A system where I used to joke that the unspoken motto becomes: “It’s not ideal but we’re going to do it anyway.” And as funny as that was, it also spoke to a painful truth: That survival often takes priority over sustainability. That maybe regaining a heartbeat is not always the same as saving a life.

I spent 11 years at the bedside and most recently over a year in leadership. I saw how meetings were run, how crises were handled, how ethics were negotiated. Slowly, over time, I started to realize: This job was costing me my integrity, my nervous system, my health, and my sense of right and wrong.

So I left.

Not because I didn’t care. Not because I couldn’t hack it. Not because I wasn’t smart enough or good enough or strong enough, but because I finally decided to protect my own life, the way I tried to protect others for over a decade.

I still love this hospital. If I’m ever crushed, burned, or paralyzed, I know without a doubt where I want to go. But if I want to save my heart, mind, and soul, I know where I can’t return.

To anyone still inside the system: I see you. I feel you. I stand in awe of your strength, heart, and resilience. You are doing impossible work. I hope one day it becomes possible to do it without breaking.

I know the hospital will keep going. But I hope, someday, those in power will understand: This work isn’t just about policies and numbers and budgets: It’s about human lives. Not just the ones in the beds but also the ones standing beside them. And too many of us are walking away: Not because we stopped caring, but because we were never cared for by a system that just doesn’t seem to know how.

Michelle Weiss is a respiratory therapist.