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On Being a Doctor |

Death and Hope in the ICU

David B. Seder, MD
[+] Article and Author Information

From Maine Medical Center, Portland, ME 04102.


Requests for Single Reprints: David B. Seder, MD, Pulmonary and Neurocritical Care, Maine Medical Center, 22 Bramhall Street, Portland, ME 04102; e-mail, sederd@mmc.org.


Ann Intern Med. 2008;149(10):764-765. doi:10.7326/0003-4819-149-10-200811180-00012
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Sitting down, looking strangers in the eye, and talking about death is part of the poetry of critical care. I sheepishly explain to friends that this is something I crave, to reach out and smooth the waves of tragedy sweeping over a family. At first I thought that I had a talent for these discussions, that they were something others avoided that I could do. But that isn't quite right. In fact, these are opportunities for performance, and I seek them out like strong coffee or difficult procedures. I like to talk to people who are reforming their lives in front of my eyes, who need certain bits of information to piece together sense from chaos. I'm not empathetic—I don't suffer with them, but I watch closely, looking for clues to what they need, doling out the little packets of information that they can use to build a framework of understanding of the future. As in poetry, an economy of information is key, and you can't rush delivery.

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