A Never Ending Battle

This is a story about a patient I took care of who had suffered multiple medical problems her whole life, and she was left with nothing except a mother who fought for her every breath, no matter the cost. This story describes a scenario commonly found in intensive care units or even on general medicine floors, one which we do not always comprehend. It is about struggling to understand when enough is enough, and how difficult it is to reach that conclusion.

She has been fighting her whole life.

She, the patient, whose every system has been wracked with relentless disease except for her beating heart. The steady rhythm keeps her alive, on the brink of viability, but hanging by a thread each and every day.

She, the mother, who has given up two other children to mortality's greedy hands. Now she fights for her third. Armor on, shields up, an unrelenting battle to keep life in her child, no matter what form it takes.

I stand in her room admiring the array of notes that decorate her walls, loving annotations written by her mother dictating which TV shows she loves, what she likes to keep in her bed, the temperature of the room that makes her most comfortable, the creams she likes to use on her raw skin. She is speaking for her, saying what she cannot, and it is touching. But when I turn to look at the blank expression fixed on my patient's face, I wonder if these are the messages she truly wants to send.

As I squeeze her puffy hand and listen to the rattle of her labored breaths, I feel her pain. I wonder where she is. I wonder if she knows how deeply her mother loves her, and most of all I wonder what she wants to say, what she would tell us if given the chance.

Hope is not always tangible. It is like a spot of light in the dark, and even the blinded will continue to search for it when all else looks black. As health care workers, we witness the battles our patients and families fight every day, we follow them along their journey and join them in their search for a miracle.

Who are we to judge?

But we do.

We hurt her. My patient, with every catheter that passes through her body, every medicine, every stick, every turn, her vacant eyes flutter with agony. When is enough, enough? Do we acknowledge the delicate line that appears before us, or sneak by without a backward glance?

The mom, who sits by her bedside day after day, encouraged by the same fluttering of the eyes, by any sign of her lost daughter. We must tread carefully, we must encourage because even a hint that hope is lost could tear her dreams apart. A whisper of three dreaded letters could signify peace to some, but to her, it is only defeat.

I wonder, what takes a bigger heart? Which battle is harder, the one you refuse to lose or the one you choose for forfeit? What if it were me, on either side? Would I keep searching for a miracle?

Who am I to judge?

But I do.