This post was written on January 30th, 2026 0400

The following is an obituary, of sorts. It is a story of a man I knew only very briefly, but who I will likely remember for a long time

Early this morning, around 330 am, we lost a patient in our care. Thirty or so minutes earlier, the hospital’s overhead pager rang out the dreaded “code blue,” followed by the room number of a patient I had met ten days ago but felt I knew so well. When we met he was already very sick, and his condition was a catch-22 scenario. He was in our care for treatment for something that would most likely kill him if left unattended, however his body was entirely too sick to handle the operation that would be the cure.

When I met him on my overnight shift ten days ago, I knew almost nothing about him. I only knew he was someone I had to watch closely in the event he bled, or suffered some other postoperative complication. I came up to his bed, and the first thing I noticed was his cellphone, placed perpendicular to his bed so he could easily watch. He was engrossed in watching, the sound turned on but to a respectable volume. On the screen, a black and white scene was rolling. Two men in hats, on horseback, weapons drawn.

I said hello, and he turned away from his screen to look at me. I introduced myself, and asked what he was watching.

“A Western,” he replied.

“I am sorry to interrupt,” I said, “but I need to examine you. My colleague will be here in a few minutes to take a look with me.”

“Okay,” he answered, and returned to his movie on the phone screen.

My senior arrived, and we set about examining him. We caused him a great deal of discomfort, which he bore gracefully. As we set him back to rights, his phone charger, which had been plugged into his cellphone, broke off at the charging site.

“Let me go find you another charger, please,” my senior said. “So you can continue to enjoy your movie.”

In the past ten days I saw this man four times on my overnight shifts. His condition progressively worsened, he required returns to the operating room for worsening clinical status. Every time, save for the last one, he was pleasant, he was calm, he only complained of the reason he was in the hospital. The last time I saw him, he was screaming uncontrollably. He was in what he called unbearable pain. He said something was not right with him. He could feel it.

He was not wrong.

The last time I saw him awake, alert, and oriented, he was in pain. He was in tears. And all the while, his Westerns played on his phone.

Yesterday morning, he had a code event. He was brought back, and upgraded to the intensive care unit. He required another operation. Afterwards, he became coagulopathic. He got transfused and was loaded on pressors. Nothing seemed to work. Overnight, he required another major operation. And then he coded. Again.

When the overhead pager rang out “Code Blue,” followed by his room number, my first thought was “This poor man is going to die.” I grabbed my things and ran upstairs. The ICU is comprised of experienced, capable people. The team was already running the code; the call had been placed to satisfy hospital policy. I knew I would have little or no role to play in the resuscitation process, but I wanted to be there. I wanted to see him again. I stood outside the door, watching the chest compressions, the monitors, the people in the room, the patient.

Compressions and pulse checks were underway, the steady tempo of Advanced Cardiac Life Support process helped along by instructions where appropriate.

“Get an ultrasound,” our attending said. “He looks like he has electrical activity. Get an ultrasound, let us check his heart.”

I ran to the ultrasound machine. The little red blinking light that signaled low battery felt like an omen. I dragged it back to the room.

“It’s not charged. We have to plug it into the wall.”

It was a futile endeavor. I knew it. Everyone in the room knew it. We had to do everything we could. We were doing everything we could. But there was nothing else to be done. The patient had been ill to begin with, and no amount of blood products or compressions could fix his underlying problem. The electrical activity on the monitor meant we had got return of spontaneous circulation, but barely so. The code event was paused. The electrical activity on the monitor was something, but in truth, for him, it meant nothing. It would last only a few minutes, and then he would be gone.

I left to go see another patient, but as I walked out of the ICU, three questions came to mind: Where was his phone? Was it on and charged? Will he ever watch another Western again?

The answer to that last one, of course, was before me. He had not yet been pronounced by the time I left, but he would be. Soon. He would never watch another Western again.

As I sit writing this, I realize I had meant to ask what the title of the movie he was watching was that first day I met him. I never did, and now, I would never know.

We do not know much about this patient. We could find no family, just two friends we kept updated on his progress, or lack thereof. To me, he was a man with a name, a debilitating medical condition, and not much more. He was also The Man Who Loved Westerns.

I hope he was loved. I hope he lived a good life. I hope, even in the midst of things, that he knew he it was time. I hope, at the eleventh hour, even as he drifted off, that he found some peace. And I hope that wherever he is going, wherever he is, he has a Western playing on a screen to watch for all eternity.