We had a patient for 6 months. Yep, 6 months. As one doctor said, “If you can’t fix whatever’s wrong with a 6 month stay in ICU, you aren’t likely to ever fix it.” Indeed. This patient knocked on death’s door several times, and even entered once or twice, only to be brought back to earth for more bedrest and bedsores.

We were really confused as to why the family would want to keep him alive in this state – they’d brought in pictures of him and he was really a very vibrant and almost regal man. Now he sits in a bed every day, breathing through a hole in his neck, being fed through a tube in his stomach. His bed was pretty nifty – it would transform into a chair position at the touch of a few buttons. We’d try to put him in this position for a few hours every day.

He’d stopped trying to communicate with us months ago. Well, he was already unable to talk because of the trach and ventilator, but he wouldn’t even look at us. He wouldn’t respond to his family either. I had the feeling that he was really in there, but was just mad. At life, at us, at his family. At his situation. But the medical system is what it is, and when he became “unresponsive,” many tests were done – CT’s, MRI’s. He was put on antidepressants, but after a couple of months was taken off because there was absolutely no change in his affect.

We carried on taking care of him. We talked to him, turned him, cleaned him – all with no response. His eyes would open, but he wouldn’t look at anyone, didn’t seem to focus on anything in particular. It was like the human-ness had just dissipated from his body. He almost became just a body that we took care of. His family would visit every day, for several hours, inquiring about his condition, asking countless questions. They’d try so hard to get to him, but he never responded. Doctors would come and go, day in and day out, and they’d try to get him to respond. He’d only rarely open his eyes. When he did, it was just to stare off into some faraway place.

This went on for months. Gradually, his labs improved. His condition overall improved and somewhat stabilized. His bedsores started healing. It soon became clear that the only thing holding him back was, well, him. We tried to tell him this, but as usual, we were only met with a blank stare, if he even bothered to open his eyes at all. I still felt that he was “in” there.

Last week, he was sitting in the bed, which was in chair position, and one of his doctors stopped by. She suggested getting him up into a chair that had wheels and she wanted me to take him outside. It was a sunny, lovely day, but I admit – I was quite sure it would be lost on him. He hadn’t been outside, breathing fresh air, for over 6 months. I was very resistant to the idea – it’s a lot of work, and I didn’t even think it would help.

But the doctor went in to talk to him and his wife, and although his face never changed when she asked if he wanted to go outside, his wife got used to the idea immediately. From getting to know her over months, I knew she wouldn’t let it go until I followed the “doctor’s orders.” Great.

I rounded up some nurses and got him into the chair. We disconnected his monitoring equipment (with the doctor’s OK) and loaded up an oxygen tank. Then we went outside.

As I said, it was a lovely day. We pushed him a few yards from the hospital, to a safe place in the shade. There was a light breeze. There were squirrels and birds. My patient had no response to this change in environment. None whatsoever. I wasn’t surprised in the least. His wife and I started talking about being outside excitedly. We started pointing out birds and trees. I felt absoutely stupid, trying to get this man who seemed so mentally and emotionally detached, who had been through some unimaginable stuff, excited about being outside.

His wife and I started talking to each other, just the usual small talk, when I looked down and noticed that my patient’s eyes were open. Well, that’s a step in the right direction at least. His wife decided to run with it – she started speaking to him in their language. Just then, a really wonderful breeze blew by, a bird sang – and he opened his eyes a little wider. He seemed to start focusing. He started moving his eyes – he was looking around! His wife was really excited, and started talking to him in that same language – he eventually looked at her, and then reached his hand out to grab hers. I doubt that I could fully explain in words the look on her face when he did that. It was the first time in months that he had communicated in any way to her.

We stayed there, outside in the sun and breeze, for awhile longer. My patient’s wife continued to talk to him in words that I could not understand. Unbelievably, to my great and utter shock, he started talking back. By this point in his hospital stay, we had been capping his trach for a few hours at a time. We would tell him repeatedly that he could talk, but he never tried – until that day. All he could manage was a whisper, and his wife was beside herself. I asked her what he’d said and she replied, “He said he wants to go home.” He managed to whisper that same phrase several more times, never uttering anything else.

After about 15 minutes, I noticed that he was starting to get a bit droopy, so we wheeled him back in and put him to bed. He fell asleep almost immediately.

After 6 months of caring for this patient, I had almost ceased to see him as human. I figured that he was so depressed he’d never snap out of it. And for all we knew, he may have had some brain damage from all those times that his blood pressure was too low – something that wasn’t showing up on all the scans. After 15 minutes of simply having him outside, he became human again. It was the greatest thing I’d seen in a long time.