Is there anybody in there? Pink Floyd
Our intensive care unit has only one room with an outside view: a window confronting a cobblestone street and the rooftops of barely preserved old buildings, but where you at least get the notion of some active life out there.
Some time ago, we treated a 28-year-old man with an aggressive pancreatic cancer. He was re-operated on a couple of times because of leakage and secondary peritonitis after a failed Whipple procedure. He developed septic shock, some organ dysfunctions, and spent several weeks in room number seven.
His name was David, and besides the medical aspects, what worried us more was his extreme loneliness. During endless rounds, we never saw anybody visiting him. Browsing through his medical chart we discovered that he was a teacher and a musician, without further details. His only known relative was an aunt. A couple of friends came to visit him from time to time and they told us that David occasionally played saxophone in a band around the traditional jazz circuit of Santiago.
Time passed by. A particularly cold and rainy winter arrived. Frequent thunderstorms washed out the city streets and squares. One gloomy day, I returned from a vacation trip to find him extubated and sitting on a sofa turned to face the window. The distinctive tone of John Coltrane’s sax overflowed from a couple of new headphones. His eyes were lost on the rain pouring down.
“Hi David! Happy to see you so well. Do you like Coltrane?” “Hi Doctor! It depends basically on the degree of melancholy, but yes. I love them all, Louis and Ella, Duke, Billie Holliday, Mile Davis, and so on.” He spoke with some effort, but never took his eyes from the rain outside. “I heard that you are a sax player, David” “That was my dream, Doctor. It is in my genes, I think. My grandad met Louis Armstrong after an epic travel from the north at a hotel bar during his only visit to Chile in 1957. But it is over now, isn't it Doctor?” At that moment, a sudden outburst of heavy rain rattled the window, followed by an uncomfortable silence, broken only by the nurse calling me to look at another patient. When I left the hospital, he was still sitting there, silent and melancholic, confronting the gloomy darkness moving into the night.
I walked home through wet and lonely streets, trying to remember a long forgotten poem “Afternoon in the hospital” by Carlos Pezoa Véliz (1879–1908), a relatively unknown Chilean poet who died of tuberculosis at the age of 28: “Over the field the fading rain/drops down softly, gently/With the drops comes the anguish/It rains/And then alone in ample room/I lay in bed, I lay sick/and to scare away sadness/I sleep”.
The next morning, he was gone, as a result of uncontrollable bleeding in the middle of the night. We stopped rounds in front of room number seven as a signal of respect. It was still raining over the old rooftops and the cobblestone street. Was this the last sight of David in the world? We felt so sad and empty. So many weeks with us, and we barely knew this man—his dreams, hopes, and fears. Almost nothing for a life gone forever. Maybe just a touch of Coltrane that kept floating around. And the last verses of a long forgotten poet who died at the same age: “But the rain sweeps down/and surrounds me/I wake up frightened/It rains/And then full of anguish/In front of the uncertain horizon/whilst the fading rain falls/I think.”
Conflicts of interest
The authors declare no conflict of interest.
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Hernández, G., Llewelyn, E. & Castro, R. The man from room number seven.
Intensive Care Med 45, 103–104 (2019). https://doi.org/10.1007/s00134-018-5395-2