a tough case

“take a minute if you need it katie, that’s a tough case”

i keep hearing the well intentioned words in my head - what the fuck does a tough case mean? it feels like an ironic understatement but nothing is funny. does tough mean watching someone die so slowly that the blood tries to leak out of their skin and the light leaves their eyes? does it mean watching bones break down day-by-day to dust made of calcium and phosphorus and hydrogen? all of a sudden we’re made of the same things as stars but the light is still gone from the eyes? i wish you were a star. you would shine so high, so tall, so bright, so clear in leading me in the right direction of what the hell to do with the privilege and burden of knowing you, loving you and trying to heal you in what feels like an exercise in futility.

i thought tough was stubbing your toe on that stupid stair step or getting a paper cut opening the mail. i thought tough was what they called me when rounded home in softball but cut my leg, my blood leaking out from the inside but then clotting and healing. i thought tough was what we did to it out, one foot in front of the other until it’s over. 

i took the minute. i washed my face and re-ponied my hair and got myself a new face mask. i came back to PICU rounds and pretended like we didn’t all just meet the reaper and hold space for the weight of imminent death to briefly visit our congregation. as if we didn’t just successfully negotiate a few more days for this one before moving rounds on to the next patient, someone who won’t meet death for hopefully many many years. 

“a tough case.”

i love words. i try to pick the right ones and learn the new ones and take back the bad ones and try not to use ones i don’t mean. i see words as the greatest tool to spread what i consider to be a super power — vulnerability. i try to use words to tell you i love you, i see you, my light is your light, your pain is my pain. i try to use words to describe the things we can’t describe about our shared human condition and connection. so, you can understand that while this case is “tough” it was so many other things too. 

this weekend i went to breakfast with the 5 other residents who spent the last month with me in the pediatric ICU. to contextualize, we worked ~ 80 hour weeks and ~26 hour shifts together for 30 days in a 10 x 10 foot work room. for weeks on end we met with death, asking for more time, trading off who got to sleep, and who held watch.

i told those girls over a table of pancakes that the last month of my life feels like visiting a planet that no one else has ever been to, except for them. they’ve met versions of people, some of whom are no longer bones but star dust, that no one else has met. they too know this deep, sorrowful grief that i feel. they were there too, for the “tough” case. i tried to choose my words carefully. in the spirit of vulnerability and community, i will tell you what i told them.

thank you for knowing what i mean when i say tough doesn’t even scratch the surface of what that place was like. thank you for showing up with me every day, despite that we show up as soldiers in a frequently losing battle. it was tough, but also worthwhile and meaningful. thank you for laughing at my jokes and showing me the light in your eyes. it helped light up the dark and macabre hallways. thank you for being the only ones to understand why i feel haunted by the third floor. thank you for knowing what i mean when i tell you i miss them.

i promise to think of you with every bright star, stubbed toe and paper cut. i promise to try to stay tough.