Hope in the Hospital

My job breaks my heart.

There is a young male patient with leukemia who will never be granted the gift of old age. He got married in the hospital today while on oxygen struggling to breathe. The couple voiced words of love, faith, and hope to each other over the beeping of heart-lung monitors and the hustle and bustle of the hospital. His brand-new spouse has to look into his eyes from across a hospital bed and know that the opportunity to wake up next to her beloved is finite. They are together taking steps into a future that they always believed would be decades long while understanding that the decades they were promised have turned into days. Against the odds they are choosing love and they are choosing each other while making the hardest decisions and fighting the hardest fight of their lives.

This is love being patient and kind, believing in all things and hoping in all things. This is living in the moment and for the moment instead of merely making plans to do better tomorrow. I wish we could all love that deeply, cling to life that passionately, and enjoy the kind of faith which refuses to believe in anything less than the best.

The subject of death is a touchy one for me right now for many reasons. As a physician, death offends me and I want badly to defeat it at all reasonable cost. As a human being, all I can do is accept what I cannot defeat. Death is a river, slow and deep, in which we all will drown. It has a defined and inexorable path, no detours in between birth and death.  One can dam the river up with sticks and concrete temporarily and one can try to change its course with C-40 but eventually the river makes its journey regardless of the shenanigans of man. My world is one where important decisions, the C-40 to change death’s natural course, are made in minutes after a screaming pager causes me to tumble disoriented out of both a deep sleep and a warm bed. As I rub sleep from my eyes, I barely have time to remember my name before I am barraged with questions for which I have no easy answers and requests that I cannot approve; I have found that 3am is often far too early to accept the consequences of my decisions, but I'm slowly learning.

I want to keep patients alive. I want for that young man to eventually leave the hospital and carry his new bride across the threshold of an apartment even though I know it cannot be. So many times, situations in the hospital are “incompatible with life,” and despite all best efforts, the river swallows yet another piece of hope. I’m never sure which breaks my heart the most – the stories and the faithfulness and the hope of the truly sick patients – my own utter powerlessness in the face of their pain and suffering and dying- or their death, which brings with it the end of their stories and which jumps up and down cruelly on their faith. It reminds me of how fragile human life is and also continuously points out to me that death cannot be stopped, no matter how hard we fight daily.  So yes.  My job breaks my heart.  And I have a feeling that it always will.