Sylvester

He was a wizened gnome like little man – wide eyes in a large glistening bald head perched upon a thin, bony body, the muscles between each individual rib struggling to suck in a little bit of precious air. He was losing the battle that he fought every day just to breathe enough to stay alive.

In this war he was a scarred old veteran of many such battles. He had just been extubated and transferred from the ICU three days before. Now the lungs were starting to fail again. The senior resident, experienced in such things, had told the naïve intern that the patient could not survive off the ventilator. His FEV was so low that he would be impossible to extubate. Now that intern was sitting in front of the old veteran trying to convince him that another intubation was futile. He would never get off. The team could keep him comfortable; use drugs to suppress that terrible sensation that he could not get enough air.

The wide eyes gazed into the face of the well-meaning intern. They were tired, tears in the corners, but not afraid. Please, he begged – keep me alive. Just 3 more months. In gasping short sentences it came out. If he could just stay alive 3 more months his wife would turn 62 and receive his full benefits upon his death.

The intern, overwhelmed, agreed. The veteran was intubated – visions of a ventilator dependent long term ICU patient in his mind.

Three days later the wily old battle veteran was extubated and on his way home, a grin in the wizened face.

It was winter about two years later when the intern – now an experienced, seasoned senior resident with his own group of naïve interns walked onto the ward to see his sixth admission of the night. As he opened the curtain a familiar baldhead was grinning at him.

“Hey Doc, remember me? I’m not dead yet!”

"Reflections" is a collection of essays by the health professionals of the Medical College of Wisconsin.