Don’t Wake Me Up Again

By: Debbie Moore-Black, RN

After 33 years as an ICU RN, I had finally decided I couldn’t do this anymore.

It was my last nightshift. The last shift that convinced me I had made the right decision.

The CNA and I went door to door to turn each ICU patient that was not capable of turning themselves.

ICU-06

Mrs. Thelma was 86 years old.

She laid in her bed slightly restless. Restrained. On a ventilator. NG tube for tube feedings. Levophed drip for a low blood pressure.

Mrs. Thelma was not able to turn herself.

The CNA and I knocked on the patient’s door. Her son was asleep on the side bed provided for families.

Her son woke up. “What do you want”? Why you waking me up”?

We explained that we had to turn his mother.

His poor gray haired mother. Attempting to extubate herself. Attempting to pull out her NG tube. Too weak to turn herself. Restrained to prevent her from extubating herself and pulling her NG tube out.

The family wanted everything done.

We turned and repositioned Mrs Thelma. We cleaned up the bowel movement in the bed and changed her sheets. I gave her a small amount of morphine ivp for comfort.

I held her hand and silently apologized to her.

I was sorry her family was not rational.

I was sorry her family thought she’d live forever

I was sorry that they were the reason she suffered so.

There was a family conference. The ICU MD explained she was going through multi system organ failure. She’s 86 years old.

That they could allow her to die peacefully.

But they wanted everything done.

And so we did. Painful day after painful day.

Every 2 hours we had to turn and reposition her or decubitus ulcers would set in. Suction her mouth and ETT, rub her back. Clean her body.

Her eyes were hazy. A living hell.

We left the room after we tucked her in.

The son announced: “don’t wake me up again”

I prayed for a peaceful death for Mrs Thelma…. but not this way.

My last night, clocking out to people who refuse to allow their loved ones to die peacefully.

I tried. I educated.

Many refused.

I could no longer deal with the torment that lies in the ICU.

To family members: We do the best we can.

We are not your servants. We are not your waitress/waiter.

We are caregivers. Professionally educated to treat your sick loved ones.

Please work with us.

We are strong…. but we are tired.

Respect and Empower.

The Prison: Covid ICU

By Debbie Moore-Black, RN

By: Debbie Moore-Black, RN

I enter the hospital to work again. I must work as I have 3 small children and a husband presently out of work d/t Covid. He is “non-essential.”
There’s a violinist playing at the employee entrance. I know they do this to lift our spirits. But it’s a slow sad string that reminds me of the titanic. And yes every day I clock in, I feel as if it’s a sinking ship.

By now we should have plenty of N-95’s, plenty of face shields and gloves and disposable gowns to enter that covid room, that Covid patient that never goes away. That continues to multiply.
It’s a painful job. I thought I would be saving lives as a nurse, but instead we are prolonging death.
This ICU is 24 beds. All Covid patients. 24 strong. I gown and glove and put my N95 mask on and face shield to enter that patient’s room. That patient with Covid… he’s 40 something, and he refused to wear a mask anywhere. Said it was a hoax. Said it wouldn’t happen to him. Spread his infection to his mom and grandmother and anyone else that potentially came in contact.
He had come gasping for air to the ED. It didn’t help that he was an everyday 2 pack of cigarettes smoker. That everyday he downed several cheeseburgers with fries and a milkshake. That every night he drank many cans of beer.
He said it was against his rights of freedom to wear a mask. He said it was a muzzle. He said he wasn’t going to be one of those sheep that follow a ridiculous rule of social distancing, washing hands and wearing a mask.

The muzzle he said suppressed his right to speak.
And now he contacted Covid. His O2 sats were in the low 80’s, he had co-morbidities like being over weight, high cholesterol, cigarette smoker and now his lungs were failing him. As Covid easily attached and infected his lungs.
It was only a matter of time for Johnny to earn dialysis, multi-system organ failure crept in. Kidneys failing, blood clots to his brain. And no matter what we did with those miraculous drugs of remdesivir and steroids, it wasn’t working. His breathing became asynchronous with the ventilator. We called it “guppy” breathing. Like a fish without water. He couldn’t follow commands. Family held tight for hope. For a miracle.
The MRI showed no activity to his brain. Anoxic injury with blood clots.
Covid rapidly ate through his body.
I pulled my work phone out, heavily encased in a protective plastic, so I could face time his family.
No holding hands. No final kiss on the cheek.
Just a final vision of Johnny.
We pronounced him dead at 0515. Notified the family. The morgue was notified. Make room for one more dead person to be stacked on top of another like multiple bunk beds.

Gave him his final bath. Toe tied him for his identity. Wrapped him up in his morgue plastic zip up bag. And we sent him off.

Clocking out we all face local police and administrators and firemen and medics cheering us on. Congratulating us. Calling us heroes.
Free pizza and ice cream for us.
And we bow our heads low.
Because we don’t want the cheering and balloons and the violinist and the pizza and ice cream and clapping hands.
We don’t want to be called heroes.

What we want is respect for each other.
What we want is for you to wear a simple mask.
What we want is for you to social distance and wash your hands.
What we want is for you to allow us to clock out and go home to our families safely without feeling that we potentially could infect our loved ones because of you being so incredibly careless.
Pay attention to science and medicine or else you may be the next careless victim.
Wear your mask.
Deal with the truth and get over your ego.

All Intensivists Are Not Created Equal

All Intensivists are not created equal.

By: Debbie Moore-Black, RN

I’d like to preface this story with saying that the majority of the Intensivists I have worked with have been exceptional, caring, and professional. We had all established a good camaraderie and we had mutual respect for each other. We worked well together.

But there always seemed to be one that was the exception.

And as I drive some long miles on a recent “get away” to the mountains…, the flashback came back to me.

Joellen was 64 years old. She smoked all her life. 2 packs of cigarettes a day. She started smoking at the age of 16. Hollywood made smoking sexy and romantic.

By the time she was in her late 50’s she developed severe shortness of breath without exertion. She had difficulty breathing. She wouldn’t put her cigarettes down.

Her physician told her: “If you don’t stop smoking for good, you’re going to die.”

In and out of the hospital she progressed to a diagnosis of CHF and COPD. Her physician told her at the age of 64 she was now considered “end stage” COPD. There was no regimen of care for her as her lungs were destroyed by her incessant smoking.

She agreed to sign a Do Not Resuscitate as she entered the ICU one last time. She did not want to be intubated. But she agreed to be medically treated.

It was now my shift. Night shift. And Joellen had a very bad day. Her breathing was shallow, her lips were cyanotic, her O2 sats were in the 80’s.

It would have been an optimum time to place her on “Comfort Care”, but the patient said she wasn’t ready to die.

Throughout the night, I watched Joellen breathe with great painful effort. She sat straight up in bed, shallow forceful breathing.

She suffered so.

I notified the “Virtual MD” to request morphine for Joellen. She had nothing ordered to ease her breathing. Even a small amount Morphine IVP could help relax and slow her breathing down without as much struggle.

The virtual MD said “no” he would not order morphine for her. I explained how she was awake and alert and suffering terribly… but he said “no, I don’t want her to get addicted to the morphine.”

I then Notified the Intensivists on call.

That was our chain of command.

Before I could explain myself to the Intensivist on call, he said to me “Do you realize you woke me up from my bed at 0300”?

I told this physician how Joellen was having shallow breathing, diaphragmatic breathing, low O2 sats and she was suffering greatly and all I wanted was some Morphine to give to this poor lady to ease her breathing and her suffering.

He let me know he would get back to me after he talked to the Virtual MD.

One hour later, I received a call back from the MD on call. Lasix 20 mg IVP stat. That will take some fluid off of her and it will help her breathing.

We don’t want her to become addicted to morphine”

And that was his answer.

And here I was faced with a dying woman. Lasix didn’t touch her. Her breathing became more shallow. Her lungs filling with fluid, barely able to auscultate. Her O2 sats slowly dropping to the 70’s and 60’s.

I sat next to Joellen and held her hand. Wanting to breathe for her. Wanting to comfort her…wanting to provide her with just a small amount of morphine…. but unable to.

I was given the most inappropriate order ever from 2 MD’s who claimed a dying woman would potentially become addicted to morphine.

Poor Joellen. As I held her hand, her breathing slowed to a minimum. She had worked so hard. Her eyes rolled back, and she let out her last breath.

I felt defeated. That a simple order from an MD could not be obtained.

Joellen died a painful death.

Eventually I found out that there was a review of this “case”.

I’m sure there was a “mild reprimand”

I drive up to the mountains. The leaves changing into their vibrant colors…

And I still see those haunting eyes of Joellen.

The Protesters

They scream and holler and march. First Amendment, it’s our right. Open up the USA.

This is Socialism. This is a hoax.

THIS, coronavirus, is deadly.

Invisible as the virus makes its trek across our USA. Across the Universe.

Nurses and doctors and respiratory therapists are being named hero’s. Signs and banners and free meals and cookies and doughnuts and loads of adoration come our way. But we don’t want to be named a hero. We are doing our job, our profession, our passion.

What the health care professionals want are safety, and protection, and experienced staff and PPE’s like N-95 masks, and gloves and gowns and face shields. And respect for this virus.

When you go out and march and protest without a mask, without social distancing, you are compromising fellow citizens, nurses and doctors and respiratory therapists. You are endangering us and your family and friends. This virus doesn’t care what you think. It searches for the next host to hook on to. Are you in your 30’s, or 40’s or 60’s… the virus doesn’t care.

Are you washing your hands with soap and water, sanitizer, keeping your distance? Do you walk freely through essential stores without a care; without a bother?

To you, it doesn’t matter.

Because you haven’t been affected yet.

Not yet.

We say our prayers going in. The hospitals test us before we clock in. They take our temperature and ask us questions. We are allowed to stay and work if we are afebrile, lack a dry cough, no loss of smell or taste, no shortness of breath, no congestion. And then we are allowed entrance to work in that ER or that ICU or any unit in that hospital. ICU’s and ER’s are now deemed as Hell.

There are no short breaks. It is 12 hours of relentless pain. Masks and shields and gowns and gloves and the very sickest Covid-19 enter our ICU’s. Pouring blood into these patients and oxygenating with emergent intubation, and vasopressins and lungs crashing and kidneys dying despite dialysis, despite our last ditch efforts of proning a patient, despite telling family members they can’t see their loved ones last breath on earth.

Despite hospitals allowing us ONE N-95 mask per 12 hour shift. Despite us knowing that this special mask should be used only once and then disposed of. Despite hospital units and surgeries closing down, despite nurses being furloughed or physicians being fired for speaking out against the lack of PPE’s, despite administrators receiving $250,000 bonus checks in this turmoil.

Frontline nurses and doctors have died from this virus helping you to survive.
Ministers and protesters, funeral sessions and greater than 10 social functions continue and you go on “blind faith.”

This coronavirus attacks our lungs our heart our kidneys and brain. It attaches and attacks until the patient goes into multi-system organ failure and then death.
To date the US has 58,947 deaths from coronavirus. This number continues to grow.
So please, help yourself to protesting, to screaming and shouting. You certainly don’t scare or intimidate this virus.

Wear your masks, keep your distance.

But if you keep your guard down, you may become the next fatal number.

Hope in the killing fields

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Our 23 bed ICU has been converted to Covid-19 patients.

All of them.

I want to tell myself this is science fiction, but it’s not. It’s real. And we are scared.
As I enter the unit to start my night shift, we have a huddle of the off-going and oncoming nurses.

We are committed to fight this invisible monster.

After a brief update of all of our patients, we bow our heads and say a prayer. A prayer to protect all healthcare and essential workers across our nation. And our Universe. A prayer for safety and strength. A prayer for the patients stricken with this potentially lethal virus. A prayer for the families that are not allowed in to see their loved ones. Not allowed in to say hello, or to say I love you or to say their goodbyes.

ICU has always been my favorite job. The dynamic and strong work here. Fearless and endless, we never stop.

But this is different.

We receive our assignments. If we are lucky, we only receive 2 patients. Both on ventilators. We have a clean nurse to assist with adding our PPE’s. We also pray that we have the right protective equipment. N-95 masks, isolation gown, gloves, foot covers, and face shield. I am the “dirty nurse”.

I have to be prepared to have everything ready to go into that patient’s room.
IV antibiotics, IV drips like vasopressin and Levophed for those dangerously low blood pressures. Lab vials for the continuous need of lab work taken from the patients arterial line. Tube feedings for their nutrition. Morphine IV drips for their pain and discomfort, propofol for sedation.

Beyond all of the technical and mandatory medical needs of this patient, I have to remember there is a person on that ventilator. A person who is all alone. There is no family member with them. It’s me and the patient. And that steady beep of the EKG monitor and the pumping of the ventilator. The noises that provide no comfort.

This virus does not discriminate.

I have 30 year old male who was perfectly healthy and I have 64 year old lady. This virus is an equal opportunity employer.

In my 30 plus years as an ICU nurse, never have I seen this incredible death threat.
I check the ventilator along with the respiratory therapists at my side. Check the settings, suction the patient. Though the patient is in a semi-chemical daze from the pain meds and sedation medications, I squeeze this young man’s hand, I let him know we are here for him. That we are going to do everything possible to make him strong again. To let him walk out of this place and see his wife again and hug his little kids again. And pet his dog again. I tell him to hang in there. That we are doing everything possible to fight this monster.

His breathing is shallow. His lungs have taken a beaten. But I can see his pulse and I can feel his pulse.

I hold his hand. And tell him to be strong. I say a pray for him. For us.

I want to shatter inside myself but I know I can’t . We must stay strong.
He turns his head towards me.

And squeezes my hand back.

Hope.

This is dedicated to all of the nurses, physicians, respiratory therapists who dedicate their lives every day in the face of danger. Thank you for all that you do.

Coronavirus

We are the land of plenty.

But not now

We stand naked.

Our America is not prepared.

With the surge of coronavirus invading our nation, nurses, physicians, respiratory therapists and medics remember our oath, our dedication and our persistence of always putting sick people first.

Everything is urgent, and emergent and downright scary.

We all worry if we’ll be infected. Will we carry this virus home to our family?

Isolation and quarantined.

The front lines are Emergency Departments and ICU’s and not only are there not enough beds, or ventilators, there are not enough experienced nurses, or respiratory therapists or physicians to spread out. Some physicians are dead. A nurse has died.

We are being told by management to use the same mask day in and day out.

Our PPE’s are inadequate and not bountiful.

An experienced nurse has been suspended because she refused to take care of a coronavirus positive patient in ICU, as she was not given a mask or gown to protect herself. Because the hospital was out of supplies.

Suspended.

Nurses are told if they test positive they must report to work anyway.

This devastating list and problems are extensive.

And there is no way out.

We are the killing fields with minimal or no protection.

I say make noise and document.
Report to the state board of nursing.
To the health department.
Report to OSHA.
This is not a hoax.
This is not a science project.
This is the real thing.

A virus spreading wildly with no vaccine.

And when the nurses and physicians and respiratory therapists and medics start tumbling down like a domino effect, in sickness or in death….

It’ll be lights out for those in need.
Game over.

This Old Man

Finally it’s time to clock out of this ICU. No break for 12 hours, we beg to go to the bathroom just for a nano-second, in between not skipping a beat to hang life-saving IV drips, assisting with central line insertions and arterial lines, and intubations of the sickest. We pretty much just go door to door literally saving lives. Code blues, and chest compressions and emergent intubations and rapid response team screams out overhead, as we are responsible for that too, and by the time it’s 0815… not 0715…. we are exhausted and haggard and starving.

We clock out and walk to the cafeteria in our

semi-comatose state. We are starving.

And there he is. Again. That old man at a table in the corner of the cafeteria. He always has a sweater on, eating breakfast and looking at the morning newspaper.
We know who he is and we’ve tried to say “hi” or “good morning” but he never looks up.

He wears a gold wedding ring.

We respect his quiet space.

He’s been there for awhile.

He is that man that lost his wife in ICU. The love of his life.
He’d slowly shuffle into ICU, with that sweater and sometimes a bow tie. He would come every day and hold his wife’s hand. And read a verse from the Bible to her. She was non-responsive. She was 82 years old. He is older. She never moves. On the ventilator, inspiratory, expiratory, the EKG monitor shows a slowing rhythm. His dear wife Ethel, is slowing down. Per his wish, he begged us and the physicians to give them both more time.

When we saw him coming, the tissues came out. It was heartbreaking.

When he did talk to us, he told us they were high school sweethearts. They met at the

Valentine school dance. Her long brunette hair. Her rosy cheeks and her eyes that sparkled.

She was the love of his life.

He went off to war to fight for his America. World War II. When he came home, he twirled her around and around and said he’d never let her go. On one knee he asked her to marry him. To live with him forever. For Ethel to be his forever. With the little money he had, he was able to buy her a small diamond. She showed it off like it was 5 carats, it was barely a 1/2 carat. But she was happy and proud and in love.

They bought their first home and proceeded with five children. All sent to college. All had jobs. She was the best wife. The best mother. And the best grand-mother.

Their children knew what they had to do growing up: Boy Scouts, Girl Scouts, church, Sunday school, homework, cheerleading and football and proms and first dates and beach trips and marriages and grand babies.

They led a good life. They had celebrated many anniversaries and their love grew and grew.

Ethel developed abdominal pain. She had been quite healthy… but with CT scans and PET scans and ultrasounds, pancreatic cancer was discovered. The prognosis was poor. The doctors advised Mr. Bill to let his wife die peacefully. But he couldn’t. And day in and day out, every day without fail, he’d shuffle in to our ICU.

We knew the truth and so did he.

And on that fateful day, it all came to a halt. He watched the erratic rhythm on the EKG monitor. He watched us do compressions, fast and hard. He insisted on her being a full code because she couldn’t die on him.

She died 3 weeks ago.

And every early morning we walk down to the cafeteria, and there he is. Sitting in the corner with his newspaper and breakfast…. without looking up.

Maybe he’s not ready to say goodbye to his wife.

We want to hug him, hold his hand, talk to him, but we respectfully keep our distance.
He’ll know when it’s time to say goodbye.

Until then, he’ll shuffle in and out of that cafeteria. Waiting.

V.I.P. Status

We were told to wear masks before entering this patient’s ICU room. Entering his room, you could smell his rotting flesh. He was 92 years old.

His skin would slough off if you dared to bathe him.

His decubitus ulcers were raging with infection.

As long as I’ve been an ICU nurse, this was the worst — the smell, the neglect, the disrespect for this man.

He was VIP status.

I always had a problem with VIP status.

Either everyone was a VIP, or no one was.

Every patient should be treated with mutual respect and care.

He laid there motionless. Pupils fixed. No movement except for a deep sternal rub we would do to check any responsiveness. He laid on that bed on a ventilator churning inspiratory, expiratory.

Who was alive? Man or machine?

Because of his sepsis, multiple-system organ failure, and his dangerously low blood pressure, we had to place a central line in him.

IV pressors started.

And we waited and hoped and prayed that his suffering would soon be over.

He came from old southern money. His daddy started up textile mills in the south. And his daddy passed his legacy to him. Preston “The Second.”

The oldest of the boys.

He would continue to spread his textile mills to Georgia, Alabama, and Mississippi.

But Preston was the king of the mills. And the king of the families that worked for him.

Sitting in his great, 9,000-square-feet Victorian house on a mountain top as his employees lived in the valley of the mill village. There were only identical two-bedroom, one-bath houses. The families that lived and breathed the mill life lived there.

During this time, textiles and cotton farming ruled.

Preston was a good man, though. He was a philanthropist. He loved the arts, and botanical gardens, operas, and Broadway plays. He loved his wife, his high school sweetheart, and his son and two daughters. And they led a good, bountiful life.

Preston financially helped his employees if they were sick or having money problems. He was their king, and they loved him.

By the time he was 70, his dear wife passed away. He was sad and lonely, and a new woman came into his life. She was full of energy. Loved the social life and gave Preston continuous love and affection. To his children, though, she was distant and superficial. His adult children caught on right away. She had her “eye on the prize.”

Preston married her. Anna had a taste for the finer things in life: antiques, clothes, dining, travel to exotic lands. Whatever she wanted, it was always the best that money could buy.

It was summertime and 80 degrees outside.

We were all working continuously in ICU without a break or quiet moment. We knew visiting hours were soon. The ICU doors opened.

In walks Preston’s wife Anna with a full mink coat, silk-lined. Really.

She wanted everything done to Preston.

And so we had to do the impossible. We had to torment this patient who desperately wanted to die.

His children wanted him off the ventilator. His children wanted their dad to rest peacefully without all of the medicines or the intrusive ventilator.

Dad wasn’t even responsive. But their step-mother insisted. Everything was to be done.

We were told by the children that his wife wanted him alive because when he died, her flow of money ended. She would only be given an allowance.

You see, Preston eventually realized what his wife was all about.

So we carried on. Turning his body. Cleaning up his feces in bed as he had no control. Washing him as his skin sloughed off.

The rotting smell of a man who should have been dead. It became unbearable.

Several days later, he finally died — his children on one side of his bed.

His wife, in her mink coat, on the other side of the bed.

Love versus greed.

We were grateful and thankful that this great man that everyone loved was finally able to rest in peace.

The brother I never knew. The mother I never had.

Originally published on KevinMD

The brother I never knew.

He was buried in an unmarked grave with other dead babies. 1960.

I am now the age my mother died. She was 64 years old: colon cancer.

She was a vacant, negligent mother.

During one of my psychology classes in nursing school, we learned about the baby monkey experiment (the Harlow experiment), where a baby monkey was laid against a mother made of wires. It was an inanimate object void of heart and warmth and touch and love.

That was a lot like my mother.

It’s interesting how I seem to have flashbacks of when I was five years old. It was 1960.

It wasn’t “nap time,” but I noticed my mother spent a lot of time in bed. I knew she was sad, and that made me sad. How I loved my mother! I snuggled up next to her to give her comfort and love. The only thing I knew was how to be next to her and maybe take away some of her sadness.

Mom came from a strong Italian family. Her father was from Italy and crossed over to America, landing on Ellis Island. America: the promised land. And to have a son in the family was the ultimate blessing.

Mom was hoping this time for a son. After having twin daughters with stark black hair and then me with vibrant red hair (dad was Irish!), this third pregnancy had to be a boy.

The golden son.

Before the age of ultrasounds or NICUs (newborn ICUs) or surfactant, modern medicine in newborns had not yet developed at the time.

After eight months of pregnancy, mom started to have contractions and vaginal bleeding — all of the wrong signs for a healthy baby. Eight months gestation was too premature.

Dad rushed her to the hospital. And after several hours of labor, mom delivered a baby boy. The Italian “prize.”

They heavily sedated mothers back then during labor. She remembers being drowsy and weak with blurry visioned. She remembers seeing the back of Terrence’s head — the name given to him. His grandfather from Ireland’s name.

But this was her redemption.

Finally, she could please her parents! A boy with olive-colored skin and black hair.

And he was whisked away. My mother would never hold and bond and kiss the baby boy.

Within one hour of delivery, he was dead.

It was called “hyaline membrane disease” — now known as Infant respiratory distress syndrome or neonatal respiratory distress syndrome. It is more common in premature infants born six weeks or more before the due date. This is a condition in newborn babies in which the lungs are deficient in surfactant, preventing their proper expansion and causing the formation of hyaline material in the lung spaces.
And my mother came home to us three girls without that bundle of joy.

A dead baby.

A disgrace.

There was no therapy sessions or grieving. Everything came to an abrupt halt.

Baby Terrence was buried in a cemetery along with other dead babies in a large unmarked grave with multiple crosses everywhere.

One hour on this earth left my mother in total devastation for her lifetime.

And she withdrew from the joys her daughters eagerly wanted to give her.

My sisters and I somehow raised ourselves. We survived.

Dad climbed the corporate ladder with IBM. Dad bought the big house, the lake house, and the matching boat. He had several infidelities, and his drinking eventually surpassed “social drinking.”

What made mom miserable and vacant was all of the above.

But grieving the death of a baby or child is considered the ultimate tragedy.

There was no “hotline.” There was no bereavement support group. Psychotherapy was looked down upon.

And so she existed day after day, year after year, mentally bypassing our growth and development, our proms, our high school graduations, and college graduations and marriages and grandbabies.

She housed herself in until her death.

On my mother’s death bed as she was dying some of her last words to my father were, “Joe, do you have the baby? Where’s the baby?”

I cried at my mother’s funeral.

I cried for the mother I never had.

As John Lennon once sang: “Mother, you had me, but I never had you.”

Don’t want to wear a helmet? Sign up as an organ donor.

Originally published on KevinMD

I walk out my front door today to do my obligatory walk around the block with my pups.

Two police cars with blue lights flashing, lead a caravan of over 100 motorcyclists to a funeral for one of their fallen brothers. They revved up their motors in the procession, I guess, as a sign of love, of brotherhood, of kindred spirits in the motorcycle world.

I choked up. I was ready to cry. It reminded me of that 23-year-old male I once had while I worked surgical-trauma ICU.

A young man riding his motorcycle with no helmet, no protection, flying freely down the highway. Superman. “I’m going to live forever.” Not a care in the world with angel dust (PCP) in his system. Feelings of freedom and forgetting any troubles.

No troubles — until it happened. He crossed the line. Killed an innocent man in a car — a deadly collision.

He came to us from the emergency department. He was paralyzed from the neck down and on the ventilator with chest tubes, fractures to legs, ribs, arms — eyes wide open. But he couldn’t blink. He couldn’t track, his pupils were irregular.

His poor mother called me every morning at 6 a.m. with a crackle in her voice.

A motherly voice of sad surrender.

“Is he any better?” she would ask.

And sadly, I would have to tell her no. He wasn’t better; he was worse.

Eventually, a conference was called with the intensive care trauma team physicians and the mother. We would withdraw life support.

And that was it.

Maybe he would have been saved had he not done drugs. Maybe he would have been saved if he had a helmet on.

Maybe.

An emergency department physician once gave us ED and ICU trauma nurses a seminar. I’ll never forget.

Don’t wear your helmet — then make sure you register as an organ donor.

In the U.S. 19 states do not require a motorcycle helmet.

Motorcycle helmets reduce the rate of head injuries by 69 percent and reduce the risk of death by 42 percent.

According to the CDC, close to 2000 lives were saved due to helmet wearing in 2016.

The blue lights passed by me. His buddies of over 100 in single file, revving their motors … and not one with a helmet.