(written, due to intubation/inability to speak; frantically gesturing):
"How long?" (gestures toward ventilator)
No, nonononono! You've only been here three hours. It's Monday, February 7, 2011. The Packers won the Superbowl last night. There was a fire in your apartment. Do you remember?
(nods 'yes'; attempts to sit up and speak)
Don't try to talk - you have a tube in your throat that's helping you to breathe. If you try to talk, you'll keep gagging. Just relax. I know this sucks. We'll get the tube out as soon as possible. We just have to make sure your lungs are alright. You might have inhaled a lot of smoke and heat; it may have damaged your lungs. I promise you, we'll get that thing out as quickly as we possibly can.
(blinks, tears run down the side of his face, nods)
I'm so, so sorry. But you're doing alright. Your vital signs are great. It's only been a few hours; don't worry. You're going to be okay.
(I lean over him, pat his chest, rub his head)
(He nods, grabs onto my arm, pulls me toward him to embrace)
You're going to be okay.
I'm going to give you some medication to help you relax and sleep. You're not meant to be awake while you have this tube in - I'm sorry you woke up. I'm going to give you this med, and you're going to go to sleep, and when you wake up, you'll be in the ICU. The fire department and police are trying to contact your family. I tried to call your wife, but there was no answer. I think the number was your home phone, and, well, the fire...
Was your wife at home with you?
(shakes head, 'no')
She'll come to see you soon. Go to sleep now, okay? Just rest and relax. You're going to be just fine. I promise. You're doing great.
(nods, holds my arm in a half-embrace while my hands do the work to sedate him)
I push 30 mg of propofol and hold his hand until it goes limp again. On the way to ICU, he awakens again (jesuschrist, how many meds will it take to keep this man sedated...), sees the tech, looks frantically around at his surroundings until I bring my face into his field of vision.
You're okay. We're going to the ICU now. Remember me? I'm your nurse. From the ER. You'll have a different nurse in the ICU, but you're going to be alright. Okay?
(nods, goes back to sleep)
There are nights I bring my work home with me, and this is one of them. I know he'll be fine. I don't make promises I can't keep. But the sheer look of terror on his face, not knowing whether he'd been out for hours or months or years... My biggest fear in life isn't cancer or heart disease; it's locked-in syndrome. Being fully alert, disoriented to time, and unable to communicate.
My prayers tonight are for him, for his wife. He could be a complete asshole in his normal waking hours. I don't care.
Sometimes the hardest part is never knowing the context of the story, the beginning, the end. All we see is the middle, the emergent, the life-or-death moments. I hope people realize that those moments aren't shared solely by the family.
We share them, are changed by them, are moved and transformed, too.