We sat in the hallway in a couple of plastic folding chairs. My patient’s mother and teenage brothers were haggard from 48 straight hours spent in the hospital, but they repeatedly declined my offer of coffee or tea. (I’ve changed some details in this story to protect their privacy.) For the last 20 minutes, the mother and I had alternated between a discussion of her hope in a miracle for her ten-year-old daughter and long periods of silence broken by the ping of the elevator and the beeping of monitors. I was just about to ask again if I could get them anything when I saw one of the residents step off the unit and head in our direction. For a moment we locked gazes. I knew exactly what he was going to say. I stood up so he could take my chair.
“I’m so sorry to have to tell you this, but your daughter’s heartbeat is extremely erratic,” the doctor began, looking at my patient’s mother. He explained that soon her heart would stop. “If it’s your wish,” he said, “we will begin chest compressions to see if we can restart her heart. But I want to be very clear with you—the outcome will not be changed. I’m so sorry, but your daughter is going to die no matter what.”
My patient’s mother looked steadily at the doctor as her two sons fidgeted in their seats and stared at their mom. She took a deep breath and rubbed her face with her hands.
