When I was pregnant and working in the intensive care unit, I disguised my growing abdomen with the largest fleece jacket I could find. It wasn’t just about my discomfort with my changing shape. There was something that felt incongruous — disrespectful, almost — about displaying the promise of unsullied new life amid all the tragedy.
So I was surprised to find myself, one recent morning, standing at the bedside of an intubated older man, talking about Halloween costumes for children. As a nurse gently cleaned the patient’s frail body, she told me that her daughter had gone as Edvard Munch’s “The Scream.” It was a hit. My 9-month-old baby girl was too young to understand Halloween, I said as I considered my patient’s vent settings. She would have more fun next year.
For my patient, and for so many of the people here in the intensive care unit, there will be no next year. I have long wondered how my frequent exposure to death affects the way I navigate the world outside the unit. But as I return to doctoring after my maternity leave, I find myself wondering how this unexpectedly all-consuming love for my radiant daughter changes me as a doctor.
This is not just about navigating my life as a physician alongside new motherhood. It is about how to acknowledge joy while experiencing loss. This is a balance that I navigate daily in the hospital, more so now than ever. I rush into the intensive care unit in the morning with the sweet smell of my baby still on me. I find myself reassuring a delirious patient with the same singsong rhyme I use to calm my child. A man just a few years older than me takes his final breaths, and when I leave his room I glance down at my phone to see a new photo from my nanny — my baby with her two little bottom teeth, beaming as she shakes a maraca.
I did not share any of this with my patients or their families, not until I found myself in the room of a dying man talking about sweet potato fries.
We all have traditions around holiday food, but for me, so many more powerful rituals revolve around hospital food. There were the chocolate chip cookies my father would buy for me as a child when I accompanied him on weekend rounds. The muffins I used to eat after long nights in residency. And now the sweet potato fries from the cafeteria. They are cut thick and are supposedly baked, and I eat them before every overnight shift.
I had an idea that this was how I would introduce my daughter to my work, to show her that the hospital is not only about sadness but also about comfort. One night, I was actually leaving early enough to feed her dinner. And so I was in the cafeteria, waiting for an order of sweet potato fries, when I ran into the wife of one of my patients. There is something so intimate about witnessing what people choose to eat in that setting, often just after we have delivered bad news, that I find myself tempted to look away. This time, it was too late. I watched her choose a grilled cheese on what would be one of the last nights of her husband’s life, and she heard me waiting for the fries. We caught eyes. We gave each other a tiny nod.
The next day, I entered that patient’s room to find a roomful of people holding vigil: His wife was there, along with his brothers and friends. My patient had entered the hospital weeks earlier for a high-risk procedure, and after a cascade of complications, he had made the decision that he did not want to undergo any more aggressive interventions. This was it. The people who loved him had come to say goodbye.
The room quieted. I had interrupted. I made small talk, placed my stethoscope on my patient’s chest, listened to the rise and fall of his breath, the gurgle of fluid in his lungs. His eyes were half closed. He appeared comfortable. As I stood there for a second, taking in the situation, my patient’s wife asked me a question. Not about her husband — she wanted to know whether I had gotten the sweet potato fries I was waiting for.
The family looked toward me, curious, clearly eager for a story that had nothing to do with illness. Happy to oblige, I explained that the fries weren’t for me. They were for my baby. With that, the tone in the room shifted. Someone jumped in. Fries for a baby! How old? Someone else asked if she liked the fries, and I had to admit that the entire plan had been a bit of a disappointment. Of course it was, my patient’s wife weighed in. Babies don’t need to eat sweet potato fries. They should just eat the entire potato. Did I not know how to cook a potato? Suddenly the entire group was offering advice. Recipes for babies. The best way to cook a potato when you’re in a rush (microwave first, then oven). The foods you should never give babies. The challenges of first-time motherhood.
And stories about their own children. About my patient as a grandfather — his elaborate pranks, the way he would always cry on holidays when the family was together. And then they were all laughing, about the foolishness of the sweet potatoes, about the jokes my patient would pull, and for a moment I saw them as they were outside this room, as they used to be when they had their own young children, when everything was possible.
When I left, I wondered for a moment whether I had shared too much, laughed a bit too loudly in a room where a man was dying. But then I heard them behind me, still chuckling as they traded stories, grasping at moments of levity. I could not bring the person they loved back to them. I could not stop his inexorable slide toward death. But I could connect with them through a silly story about my baby and maybe a reminder — however small — that there is life even in loss.
That night, I returned home too late for dinner with the baby. It had been a hard day in the unit with a mother whose adult child had suffered a catastrophic brain injury years earlier and would never wake up. It is impossible for me not to think of my own child in those moments, to feel that chill that goes through me as I am reminded, once again, of how quickly good fortune can change.
When I arrived home, my daughter was already in the bath, splashing about and babbling with her bath toys. I washed my hands, scrubbing away the layers of the day, and then I scooped her up from her bath, warm and beautiful and gentle in her baby bath towel. When I kissed her, I thought of the mother in the unit, I thought of the family holding vigil at the bedside, and then she giggled. And the hospital faded away and I was with her, in that moment.
Maybe that is the best I can do. To be present both at home and in the hospital, in the joy and the loss. To laugh about sweet potato fries. And to love, knowing it is all precarious.
Daniela Lamas is a contributing Opinion writer and a pulmonary and critical-care physician at Brigham and Women’s Hospital in Boston.
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