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“The reality is that the lives of the smallest patients are in our hands, and their clinical condition can change in an instant. No matter how many times you are involved in situations such as this, the physical stress and anxiety as well as the emotional and psychological effects of being immersed in that environment are dramatic and lasting on the human body, mind, and central nervous system. These effects are severe, and I firmly believe that they are cumulative over your lifetime.”

“The entire belief was insulting to many of us, but nonetheless, the term “top trained,” which would come to be regurgitated with great regularity by hospital administration and by Dr. Kowatch, would eventually evolve to become what I would describe as an unhealthy infatuation, one that I now understand represented the developing disconnect between the majority of the Heart Center team and hospital administration, which would ultimately have detrimental effects on the program, which would become visible to all in the near future.”

“They remained imprisoned in the CICU, kept alive in physicality by mechanical devices and medicinal support, inexorably suffering. I revered their resiliency, though I struggled to understand whether they were truly resilient or if this was a descriptive term I used to assure myself that what we were doing was just. Could they merely represent physical beings at this point, molecular derivatives of carbon and water, void of souls that had moved on months prior once the universe had delivered their inevitable fate, simply kept alive by us physicians, who ourselves clutched desperately to the most favored of our prehistoric binary measures of success: life?”