Our uncaring electronic medical record,

Often inhumanly growing colder,

Today has added a cake to your date of birth,

To indicate your age turning one year older.

It’s a day that should be celebrated,

Even while here fighting for your life.

It’s a moment that brings a sense of family,

Being bedside during this intense strife.

Your room gets whimsically decorated,

With birthday cards up on the wall.

A touching show of humanity,

If only you were aware enough to see it all.

It happens so suddenly,

Yesterday, you were talking and awake.

You’ll spend more time with your daughter you said,

Since there’d be less business trips to take.

Now a piece of birthday cake

Sits alone and uneaten on the sill.

Your level of consciousness continues to drop,

As we try to save you still.

I stand there watching your intubation,

Birthday decor still on the wall.

The fortunes of fate can seem so cruel,

One moment you’re up and next you fall.

The odds were grim from the very beginning,

Despite treatment with powerful fungicide.

We worry that we cannot save you,

And that your dates of birth and death will soon coincide.

Your family knew your wishes,

They knew how you wanted to live.

So we free you from your tubes and gadgets.

And for any faults, we ask you to please forgive.

Poet’s Statement

This poem is a reflection on those rare moments in the hospital when we stop to acknowledge our patient’s and our own humanity. This particular patient encounter was made even more poignant but with the sudden decline and a transition to comfort care. The boundaries between doctor, patient, friend, and family become blurred as we try to respond to the precariousness of life. The realization that just the day before, a patient could be talking, expressing regret for not having spent more time with his child, while the next day he could be emergently intubated for altered mentation, is one that I will carry forward with me.

In a sense, each day for us is a “birth day,” in which we should celebrate and commemorate our birth/rebirth, and seek to grow and connect with those around us. Celebrating a patient’s birthday in the hospital gives us a moment to recognize—with all our technology, advanced skills, and knowledge—that medicine is really about people taking care of people. And in doing so, we are trying to treat the body, the mind, and the soul.