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I Wish I’d Known

From the computer screen a few inches away, Oliver’s honey-brown eyes gazed into mine in the unadulterated way that only children’s eyes can, matching the directness of his question:

“Is he going to die?”

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The Other Side of the Mask

I don’t know what it’s like on the other side of the mask.

Not the cloth mask, which I now wear every day, as habitually as my socks. I mean the plastic bipap mask, which provides the highest level of ventilation COVID patients can receive, short of intubation.

That mask.

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A Time to Mend

“After eighty-five years of life, I still don’t know what death is,” said Lonnie, as I sat beside her bed in the nursing home. “I just know it scares the heck out of me.”

Despite decades as a hospice social worker, I don’t know what death is either; but I’ve spent much time with patients exploring the question together.

“What scares you?” I asked.

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Blue Book

Days before she died

my mother stood in line,

took a picture for a passport—

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Ghosts

For months, as I’ve visited Evan as his hospice social worker, he’s been praying to die. In his early nineties, he has been dealing with colorectal cancer for more than four years, and he’s flat tired out. As he sees it, the long days of illness have turned his life into a tedious, meaningless dirge with nothing to look forward to other than its end. He’s done, finished. He often talks about killing himself.

On

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Things My Wife Left in the ICU

A pacemaker and defibrillator

Sheets pressed hard with suffering

Seven fingers and one arm, gangrenous dead

Unknown liters of blood

Failed kidneys

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I Would Like to Call It Beauty

Gearing up for my night shift in the COVID-19 intensive-care unit, I don my personal protective equipment (PPE)–a white plastic air-purifying respirator (PAPR) hood. The hood connects via a tube to a large battery pack that I strap onto my waist over my scrubs. I turn on the battery and shiver when the rush of cool air blows past my ears. I walk into a bright white antechamber where a safety officer inspects me.

“You’re

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In the Biodome

In the Biodome

As a pulmonary and critical-care medicine fellow, I care for patients with a broad variety of respiratory ailments. But little did I know, as I examined my patient Mr. Smith in the outpatient pulmonary clinic this past winter, that I’d see him again only months later as my first patient with COVID-19.

Mr. Smith was tough as nails. A stoic retired steelworker and former smoker, he suffered from significant emphysema, but was inclined–by nature and

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A Flower in Winter

A Flower in Winter

It’s winter of 1993. A cold, snowy day. Windy. A blizzard. The phone rings.

I’m not on call for my patients today–except for one. Daisy has been in my care since the early 1970s, and given the risk that she may suffer a serious downturn, I’ve instructed her nursing home to call me whenever necessary.

This is that call. Daisy, my dear lady, the old artist, is dying.
Throughout her nine decades of

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Prayers of Passage

The day began in Mom’s room with a 10:00 am conference at Upper Valley Medical Center, west of Columbus, Ohio. In attendance were my ninety-three-year-old mother Joanne (now in her third week of hospitalization), her palliative-care nurse Richard, her Episcopal priest Mother Nancy and myself.

Mom was on high-flow oxygen therapy delivered through a nasal cannula. Despite this, her blood-oxygen levels were well below normal. Clearly, her lung function was declining. Her heart

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First Time, Last Time

“Deeper compressions! Deeper! Make sure you get that recoil!”

I push harder and lift off higher. I’m starting to sweat. My stethoscope is banging around my neck. I should have taken it off, I think. My hair is flying around my face. I should have tied it up. I’m on tiptoe; my legs are cramping. I should have stood on a step stool.

“All right, she’s getting tired. Next!”

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Every Doctor’s Nightmare


Bobak Akhavan ~

I was an intern, doing a rotation in the coronary-care unit (CCU) of a large urban hospital. It was very challenging: The patients had complex medical issues, and my fellow residents and I were given lots of responsibility for their care. Still, I felt I was finally getting the hang of residency.

One of the first patients I saw was Mrs. Smith, a middle-aged woman who had come to

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