Today was difficult.  Yes, I wanted to cry and felt horrible because of two tragedies I had to deal with at the hospital this morning, but that isn't exactly why it was difficult.

The weather is fairly nice here in New York today, and I started out in quite a good mood.  I had a good night's sleep (I am on call for emergencies at the hospital this weekend), and only had one patient to see (so I thought) at the hospital.  I'll call the patient I had to see Jenny.  Jenny has been in a coma for two weeks after suffering a cardiac arrest.  She is close to my age.  Her family has constantly been at her side and we have gotten to know each other somewhat under these difficult circumstances.  Jenny showed signs last week that perhaps she would come out of her coma.  I am the eternal optomist and although very cautious with the family, gave them just enough hope so they would not give up.

I entered Jenny's room today, hopeful that she would be making progress.  It was not to be.  Jenny is brain dead.  I stood at the foot of her bed for a moment, wondering what she must have been like in life, how we might have gotten on, and reflecting on my own mortality.  That, for me, is always difficult.  Life can end at any moment, and that scares the heck out of me.  As I stood next to Jenny, paying my last respects and wondering how I was going to break the news to her family, I was called to the emergency department to see another woman.  She too was in a coma and I found her to also be brain dead.  There was no escaping or retreating to collect my thoughts.  Both her sisters were there and wanted to know what had happened.  I went into robot mode.  I told them everything, as gently and compassionately as I could, touching them gently on the arm as I finished.  I walked away as they sobbed for their dead sister.  I stayed numb.  I still had to speak with Jenny's family and made my way back to the intensive care unit where I knew they were now waiting.

I brought Jenny's family into a private room and told them the news.  Her brother and father knew this was coming and their eyes welled with tears.  I was numb again.  When you do this a few times, you begin to condition yourself to being numb and putting up a wall.  Otherwise you fall apart.  I hugged Jenny's brother and father as we parted. 

Today was difficult.  But not so much for me as for Jenny's family and the other woman's sisters.  I get to come home and watch the history channel with my two cats.  They are now planning two funerals.