I always look forward to interdisciplinary rounds. I’ve worked with most of the team members for years and enjoy the differing perspectives and collaboration. Today is no exception; I know my patient very well, as he’s been in the ICU for months. As the interdisciplinary team moves through the ICU like a small mingling mob, pausing at each room for a brief nursing report and lingering for discussion, I stand in anticipation, ready to present my patient’s case.
My report, though, is politely cut short by the medical director.
“What’s changed?” he wants to know.
And I feel pressed to produce some crumb of improvement.
“Well…” I say. “He kisses his wife. His GCS* remains eight, but he kisses his wife.”
A few people smile, and I hear a few chuckles.
“It’s a reflex!” I hear someone say as they move away.
I know, of course, how little the kisses mean from a medical standpoint. His initial injury was neurologic, and his neuro status is quite compromised, but stable. His cardiovascular, gastrointestinal, and genitourinary systems are stable, as well. It’s respiratory insufficiency that keeps him in the unit. Puckering his lips in response to his wife leaning towards him is not significant and likely doesn’t change where he is or where he’s going.
And yet . . . his wife, Linda, crosses town every day on a city bus to come and see him. She calls us en route, and we slide him into a cardiac chair before she arrives. She spends hours with him, rubbing hospital-grade lotion into his hands and feet as she chats with him about the details of the life she’s navigating without him. She works each of his joints in turn, counting the repetitions to the beat of country music. She’s made his ICU room homey, even hanging a vanilla scented, tree-shaped air freshener from his IV pole, which I find particularly touching.
I sit, charting, and watch them out of the corner of my eye. I’m distracted by the beauty of Linda’s devotion. There’s a quality to her interactions with her husband that feels rare and that I find difficult to describe.
I love it that he kisses his wife. The act itself may hold no medical significance, nor does it signify romantic love. But what I sense in them is more profound than romance, and because of that the simple kiss seems deep and intrinsic.
Perhaps, in that way, it is a reflex, after all.