Centimeters Away From Brain Death

I walked onto the chaotic neuro intensive care unit and saw a bed was missing. Great. They probably had to take that patient to an emergent CT scan.

I looked down at the assignment.. and, of course, it was my patient.

After I get report on my more "stable" patient, the night nurse is back from CT with her patient to give me report.

He's in his early 30, two kids and a loving wife, and a brain tumor the size of a banana in his head that's begun to press on his brain stem. He'd been having headaches for weeks and last night was confused, so they brought him to the emergency room, where they did the CT scan that showed the massive tumor.

The nurse had been pushing all night for him to get an emergent debulking of his tumor because his neurological exam was worse and worse. The neurosurgeon walks on the floor the second I finish writing her report down.

Emergent MRI. Emergent intubation.

The doctor quickly got consent from the confused family. Emergent right craniotomy for tumor debulking and biopsy, the consent read, with his wife's shaky signature at the bottom.

As soon as he left, they asked me, "what did he just say?" I had to explain to him that if we don't go now and relieve the pressure from the tumor now, he's going to be brain dead in a matter of hours. The blood left their faces as tears began to cover them. I awkwardly hugged his crying 14-year-old daughter.

As I was packing him up to go to the OR, I tried not to look at his son and daughter sobbing over him, telling him how much they loved him. I pretended I didn't see his wife give him 20 tear-soaked kisses on his neck.

I whisked him downstairs for the quietest, yet most emotional, elevator ride I've ever taken.

They said what they thought may be their last goodbye as I turned him down the hallway to the OR. No pre-op for us. We were going straight back to the operating room.

It's only 1023.

I get him back from the OR unrecovered after about two hours. By the end of the shift, he was stable, but critical. His family was a mess.. sitting there, staring at him. It's like they were just watching his chest rise and fall, rise and fall. Somehow, that was all they needed in that moment.

I gave report and left. I had two days off and when I returned, he wasn't in our unit.

My day was so busy and difficult, I didn't have time to figure out what happened to him. At 1600, I tried to slip away to eat something. As I was walking towards the break room, there he was.. walking towards me. Him, his wife, and two children were smiling at me, as he walked down the hallway with a walker.

I almost didn't recognize him without that breathing tube. I immediately recognized his family though. I'll never forget their faces.

I couldn't breathe all of a sudden. They literally took my breath away.

They said thank you, gave me a card, and told me to open it.

"Thank you for saving my father's life," it said in his daughter's handwriting.

I started sobbing in the middle of the busy intensive care unit. I had to leave the room to gain my composure. I gave them all a hug that probably had tears and snot mixed in. At that point, I didn't care what I looked like or what I got on them. I was just glad I could look at him, standing up face to face, and give him a hug.

He was extubated the next day. Transferred to the floor the following day. Going home today.

He was literally centimeters away from brain death 48 hours ago and he's going home today.

And it was a Tuesday.