The Short Jacket: Navigating the ICU With Head and Neck Cancer

Reflections on the wonders — and the hierarchy — of modern hospital care.

Four nights after a 20-hour surgery, my breathing started to fail

so the hospitalist transferred me to the intensive care unit (ICU).

A new doctor entered my room there the next day, all alone.

The surgical team asked him to review my case, he said,

to figure out why there was not enough oxygen in my blood.

It seemed odd that he had no entourage,

no one else dressed in white coats, blue scrubs or nursing uniforms.

The reason was clear once I noticed his short white jacket.

That explained why he worked solo, straining to deepen his voice,

trying to appear older than he was, posing as an MD at all.

Still muted by the trach tube and post-op swelling,

I jotted a cryptic note to my wife: “SHORT JACKET.”

She smiled with a shrug, clueless.

I wrote again, frantically: “MED. S.”

I had a bad feeling about this.

For the next three days he brought more questions,

more warmth and more sensitivity.

He was no longer pretending.

I relaxed and opened up.

We connected and trusted one another.

By then I understood it was the pain medicine

that caused my blood oxygen to fall so low.

Back on the surgical floor a few days later,

free of pain meds, breathing normally and getting ready to leave the hospital,

I reflected on the irony of it.

Who figured out what was wrong with me back in the ICU?

No one took credit, and that made me uncomfortable.

Resting at home a week after that, as fears of the crisis fade,

I sense my mood turning toward reflection and hope.

My thoughts go back to the medical student.

I hope he was the one who looked it up, wrote it down,

figured it out, and kept his cool among the real hot shots,

the ones in the long, crisply starched lab coats.

I hope he gets into the finest residency program on the planet.

I hope I conveyed my sincere thanks to him,

whose name I was too preoccupied to write down.

I hope the people in the ICU keep figuring it out

not just the ones dressed in jackets, lab coats and uniforms

but especially those dressed like me, in a flimsy hospital gown,

frightened and exhausted.