The title refers to the way anesthesiologists describe their job.
They said yes to ECMO.
It's been two days of exultant highs, white-knuckled lows. You float peacefully along the riverbed we carved out for you, like the dreamers that we are, until you catch, you snag, you tear. You break.
We patch up the hole, we sew the pieces back on. We mend you with tight lips and grim faces. Every victory snatched away from us too soon.
We bolus you over and over to stop your coughing. We watch your pulse ox saturation nose dive and sit at a breath-taking low, the seconds ticking by ever-so-slowly.
Fuck it, I say, I'm restarting paralytics. I reach for the line. Almost as if responding, your sats jump up into the 70s. My finger pauses on the button. The attending appears, and gives me the go ahead. We paralyze you. We pump up your blood pressure with pressors, trying to repair the damage we've done with our other drugs. Your head lolls, rag-doll-like. Behind us, the photos of your life (jet-skis, graduations, and sunny days) seem to call out in sudden pain.
No options, we say to the family. No options, we say to ourselves.
What will happen to you? Can you survive every odd, can you hang on through ECMO, physical therapy, waiting for lungs, and a high-risk surgery?
I want to hope, but somehow... I just don't think so.