I am a clinical nurse in the Medical-Surgical ICU at University of California, San Francisco. I photographed this question which was written by one of my patients this year. The patient was a young woman on a spontaneous breathing trial, awakening from sedation with propofol. Her mother and I were attempting to communicate with her as she emerged from 2 days of sedation. The patient, recovering from stem cell transplant and severe graft versus host disease, had been ill for months, during which time her mother was her primary caregiver.

She asks “Am I dead?”, a reflection of the delirium she was experiencing. It was a very poignant and emotional moment for her mother and me. Despite her confusion, she carefully punctuated her query with a question mark.