(CW: cancer, and death in a hospital. This thread is based on something that happened 20 years ago, as told to me by people who were there.)

There is a quiet calm that descends when the final decision has been made.

When there’s nothing left to do, but wait.

And reflect. 1/
The room is in a corner of the ICU, and for the past week it has seen a struggle unfold.

An elderly woman lies in her bed, connected to a ventilator and an intricate web of intravenous drips.

She is frail, emaciated, her body ravaged by cancer.

Mercifully, she is comatose. 2/
We often think of illness as a battle, with the victors and the vanquished.

Except that’s never really true.

In the end, there are no victors.

We say, “Be strong!”

But there is no strength or weakness here.

There is only the journey.

And all journeys must eventually end. 3/
For most of her stay, the elderly woman has been cared for by the same nurse.

As with all her patients, the nurse has done her best to get to know the elderly woman.

She has cared for her with great skill and knowledge, attentively and compassionately.

She has cared deeply. 4/
But sometimes, no matter how much we care, there are some things we cannot change.

Slowly, Death has made its way towards the room in the corner of the ICU.

Now all the family are arriving to say goodbye.

And something magical begins to happen.

Stories begin to be shared. 5/
The nurse listens, as she stands by the bedside.

Over time, she has learned who all these family members are.

The elderly husband and daughters who have been at the bedside from the beginning.

Sons, nieces, nephews, cousins, grandchildren.

Family trickle in. 6/
Some are in town. Some have driven a few hours. Some have flown in from across the country. Some have flown in from across the world.

A great love once existed here, and it exists still.

Breathing life into the bonds between them.

Bringing them together.

Stories. 7/
They share remembrances.

Laughter mingles with tears.

Recollections of kindness.

“She used to take care of homeless people near her house. Nobody knew, she never told a soul. When she got hospitalized, all these people showed up asking if she was okay.” 8/
“She was the best cook, I swear, I’ll never forget her recipe for eggplant.”

“And the kababs?”

“Good Lord the kababs!”

“Heavenly!”

“Exquisite!”

More smiles, murmurs of agreement.

The nurse smiles softly, wondering what delicacies those pale fragile hands had once made. 9/
“Did you know she rode horses as a young girl and teenager?”

“WHAT?!”

“Yes! She was a free spirit back then. I suppose she always was. It never left her. The way her eyes would sparkle when she set her mind to something.”

“Strongest person I ever knew.”

“Amen.” 10/
The stories are a window, and through them, the nurse begins to hear a voice from the past: her patient’s voice.

As she is mechanically ventilated, she speaks.

As she lies motionless, she stands tall.

As she is dying, she comes to vivid life.

The nurse fights back tears. 11/
There is a quiet calm that descends when the final decision has been made.

When there’s nothing left to do, but wait.

And reflect.

The family has gathered, to wish a fond farewell at the end of one journey and the beginning of another.

Where all roads meet, then diverge. 12/
This is a time for tears, and that’s okay.

This is a time for grief, and for the gentle wisdom that comes from letting go.

As she dies, and her delicate breaths finally stop, her small hands are held in her husband’s.

He whispers a promise to be with her again, someday. 13/
The nurse sees everything.

Bearing witness.

She stands with one foot in each world, that of the beloved and that of the patient.

Perhaps more than anyone else on the healthcare team, she understands what has truly happened here.

She is intimately familiar with this story. 14/
Time passes.

Twenty years.

The nurse was young back then, but now she is a seasoned veteran.

And now she holds a phone up, so that a family can look upon their dying loved one from afar.

And she remembers sadly what it used to be like, before,

where all roads meet.

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Sayed Tabatabai, MD

Sayed Tabatabai, MD Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @TheRealDoctorT

13 Oct
In line to vote early in San Antonio.

Have never seen it like this.

Nobody’s quite sure where the line starts. Everyone says to get behind “the guy with the purple hair.”

Fortunately he’s tall, and an easy landmark.

He seems unaware that his hair color is so clutch.
There’s an easy camaraderie. I think after all this isolation, it’s strangely reassuring to see so many people sharing a purpose (and wearing masks).

I feel hopeful, genuinely.

People keep filing in to join the line and I’m getting a kick out of the looks on their faces. 😮 2/
Ok we got our first “Aw hell naw!”

Someone walked in, saw the line, and said “Aw hell naw!” before turning around and walking away.

Weirdly their shirt said “STAND AND FIGHT!” with a rifle and a US flag.

Not sure what the significance is there.

The Line chuckled. 🤷‍♂️ 3/
Read 6 tweets
12 Oct
We begin our visit.

In your hospital room, sunlight streams in through the windows.

Motes of dust hang suspended in the air, sparkling like some ancient magic.

You lie in your bed, propped up by thin pillows, on standard issue bedsheets.

We assume our roles. 1/
We go through the rituals.

We speak the words, and have the discussion. The updates, the options, the plans, the understanding.

When it’s over, you fall silent, then curse.

I think it’s at me, and flinch involuntarily.

Then I realize.

You’re looking at the TV. 2/
My gaze follows yours. It’s a football game. Ah, Sunday.

“Damn Cowboys. No defense.”

I nod, “Mind if I join you for a bit?”

“Go ahead doc. It’s gonna be bad for your mental health.”

I laugh and sit down beside you.

Together, we watch and criticize the coaches. 3/
Read 7 tweets
3 Oct
((The following thread is part three of my “Sherlock Saturdays” series. The story is titled “The Invisible Army.” A link to part two (and part one) is provided below.

Sherlock and Watson travel to Chatsfield Manor in 1890, after getting a mysterious letter asking for help...))
The gentle rocking motion of the train is soothing. I find my eyelids growing heavy.

Holmes sits across from me, his gaze fixed on the English countryside as it flashes past the window.

The urge to ask him what he’s thinking is strong, but I don’t.

Somehow, he senses it. 1/
Arching a brow in that way that is uniquely his, he looks to me.

“What is it Watson?”

I hate it when Holmes’ powers of deduction focus on me, so I lie, “Nothing.”

“Nonsense. You wanted to ask me a question. Ask it.”

“Just wondering what your thoughts were, on the case.” 2/
Read 23 tweets
30 Sep
Wake up with a strange feeling in the pit of my stomach.

Not quite anxiety, not quite fear.

Shower and it doesn’t go away.

Drive to work, construction on the roads, take the detour. Park and exhale, overcome inertia and get out of the car.

The air is unexpectedly cool. 1/
A man sits on a bench outside the ER. Torn jeans, hollow gaze.

He nods hello to me. I nod back.

Masks hide facial expressions.

I walk past, into the hospital.

COVID screening. Point the infrared thermometer gun at my forehead and pull the trigger.

Beep. Good. 2/
Get on the elevator to the ICU. It’s no longer a “COVID unit,” but I remember when it was.

This used to be the Monster’s lair.

We didn’t kill the Monster. It killed us.

200,000 of us.

And it’s waiting, biding its time, prowling, invisible.

Seething in silent fury. 3/
Read 11 tweets
23 Sep
Some thoughts/comments on my last thread.

I took some time to digest everyone’s responses.

First and foremost, people wanted to know that my patient was okay. He is. We were able to find a good path forward. My office staff and I have learned to navigate these issues. 1/
Many people offered money, from here in the USA, to Canada, Australia, Peru. There were many requests for me to set up a GoFundMe.

If we were to set up GoFundMes for every patient we saw who was dealing with similar issues, it’d be our full-time jobs, and not a solution. 2/
Many people shared heartbreaking stories of their own, that were moving, infuriating, powerful.

One of the reasons the thread resonated is because of how universal the experience is.

It told us truths we already knew. 3/
Read 9 tweets
16 Sep
“Why do you want to be a doctor?”

I answer without hesitation, “I want to help people.”

“There are many ways to help people.”

“I want to save lives.”

“There are many ways to do that too. So I’ll ask you again, why do you want to be a doctor?”

“Because I believe in it.” 1/
I think about that exchange now and then, some times more than others.

Why do we do the things we do?

What do we really believe in?

My next clinic patient is one I’ve known for many years. He is visiting me today via Zoom.

I always look forward to talking to him. 2/
As soon as the visit begins, I notice that his camera is angled off-center so I can’t get a clear look at his face.

I ask if he can adjust it, but he says he’s having technical issues.

No problem. I can adapt.

It isn’t just the camera though.

Something feels off today. 3/
Read 13 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!