With every patient we see in the Intensive Care Unit, we have hope. We have hope that they will survive their critical illness. We have hope that they will recover and walk out of the ICU alive and well. We have hope that they will survive their ICU stay intact: physically, mentally, and spiritually.

Then came the scourge of COVID-19.

In the beginning of the pandemic, we had that same hope for our COVID-19 patients. We had hope that they would survive their critical illness. We had hope that they will recover and walk out of the ICU alive and well. We had hope that they will survive their ICU stay intact: physically, mentally, and spiritually.

Some did just that.

But many, many, many others did not. And the repeated crush of death after death after death after death has taken a severe toll.

And so, now, I no longer use the word “hope” when it comes to patients with COVID-19. The repeated crush of death has become much too painful.

Now, I just live day by day with my COVID patients in the ICU. If at the end of each day, the patient has survived without death or major complication, I take it as a win. We made it through this day, and we will see what tomorrow brings. But I actively suppress using the word “hope,” because I just can’t take another death to crush that hope once again.

The fight for the patient hasn’t eased one bit. The relentless pursuit of whatever we can do to help our patient remains. We still sweat, and toil, and battle for our patients each and every day.

But for me, I have stopped using the word “hope.” The repeated crush of death has become much too painful.

The only time I will celebrate is when I physically see the patient leaving the hospital alive and well. It is then that I will finally crack a smile, sigh a breath of relief, and embrace the warm feeling that comes when seeing our patient be liberated from the prison that is critical illness.

And it is then, and only then, that I will have hope that our patient will become whole once again.

But in the depths of the ICU, as I watch COVID-19 ravage my patients day after day after day without mercy and without end, I do not use the word “hope.” I can’t use the word “hope.” The repeated crush of death has become much too painful.