Futures

on the glass. That afternoon, it was me holding a phone to the patient’s ear, sweat-drenched under a gown, hearing his daughter choke out the words “I love you, Dad” over and over in the twelve minutes that it took for him to die after his extubation. It’s hard to say if the nightmare was worse. At least in the nightmare, I eventually woke up.

I felt the way a doctor should never feel: I was relieved when they died. As I become further removed from those days, that sentiment is harder to justify. But in those dark months, it was freeing to let go of the kite strings being pulled by hurricane winds. We were lost in a storm that we were powerless against. The relief was born of repetition; these catastrophes occurred several times a day. They were perpetual conversations held with gentle honesty about the futility of the care we were providing. They were experiments in decay throughout a 44-day ICU stay, during which families tested a theory that God would save their son, uncle, brother. It didn’t feel like God was really there. The only clarity we had was grim: they would all die. It wasn’t hard to explain to the families how the body was dying. It was hard to explain how the future was dying. Everything that made this body a person was no longer a possibility. We overused the phrase “Even if”:

”Even if his tattered lungs were to recover to the point that we could take him off this ventilator…”

“Even if he could learn to walk again after a month of paralytics…”

“Even if he were to recover neurologically from the innumerable strokes he suffered due to his hypercoagulable state...”

I fought the urge to jump to my feet and shout, “Even if he opened his eyes right now, he would beg us to let him die.”

A year had passed before I felt once again that sense of vacuous loss, but I recognized it immediately when it arrived. It made no difference that the culprit was leukemia rather than a virus. The words were nauseating in a familiar way when they came out of my mouth, like a poorly made sequel. The same blank stare emerged on her face that I had seen, by that point, at least one hundred times. He was obviously dying: two bruised and bulging eyes where the immature

cells replicated furiously, the cloudy ET tube, the cherry red urine. Relaying this in the conversation was always difficult, but it was the aftermath that was the most damaging.

I thought back to the phone calls I had made, one morning telling a 15-year-old girl that her 42-year-old mother had died. I wondered about her often, even when it was inconvenient. While washing my dishes in my apartment, I would wonder who made her dinner that night. I would order a bourbon at the bar and wonder who would take her photos at prom. A ventilator alarm snapped me back to the present.

I watched the woman in front of me touch her ring and wondered how soon she would take it off after he died. It would shimmer in the sun the day of his funeral, gleaming above the casket being lowered into the cold earth. She would never hold his hand and walk down the aisle. She would never again wake up in the middle of the night to see his face or fall asleep to the slow cadence of his breath. I knew I’d wonder about her from time to time in ICU rooms to come.

We stood motionless on opposite sides of the hospital bed. She began to cry, and I selfishly felt a twinge of my own sadness. I thought of the face I used to see so many mornings after opening my eyes to a predawn alarm, silently slipping into scrubs to avoid waking him. An hour before sunrise, only his dark tangle of curls was visible on the pillowcase next to mine. During the bleakest days, I breathed slowly through an N95 mask and dreamt about our future, the happiness that had to lie ahead after all of this. I would think of the time before,

sun drenched days sitting with him near the vineyards, cold nights when his smoky flannel kept me warm. The luxury of watching him walk into the hospital, carrying a cup of coffee to keep me awake. The champagne trepidation of the day that he, too, would slip a ring onto my finger. The happiest day of my life. A day which, of course, never came.

Consumed by the loss of dozens of futures I couldn’t preserve, I watched ours slip away too, standing on the wrong side of the metaphorical glass. No disease to blame for his departure, he was alive but out of reach. photograph that I had not noticed before, in which he was with his fiancée, smiling broadly from a balcony somewhere tropical. Somewhere else. When I saw it, I excused myself from the room. The glass door clicked shut behind me, and I felt the full weight of two years’ worth of grief. As if for the first time, I stood in the noisy hospital hallway and mourned both futures, robbed from the living and the dead.

Suddenly and somewhat uncharacteristically, tears welled in my eyes as the patient’s fiancée asked a question about chemotherapy. Taped to the wall across from his bed was a 23