Something like No Problem by the Chet Baker Quartet was playing in the ICU. It was one o’clock in the dark of the night. The barbershop was open for business.
Having been assigned to the Trauma ICU for the past week, I was comfortably familiar with the patients and their stories. I rounded on the unit at the start of my shift, making small adjustments here and there and hoping for a quiet night.
I began by saying my hellos to the family in bed 2, each relative clutching a hand and praying that the young woman, many years my junior, whose brain had swollen as a result of her injuries, would win the fight for her life. Visiting hours had ended but they were allowed to stay late given the circumstances. I drew the curtain behind me.
At the other end of the unit, the woman in bed 13 was no longer calling out or squirming restlessly. She had learned earlier in the day that she was the sole survivor of the crash. Her eyes remained fixed on the wall clock when I entered the room as though she was counting down the minutes until she could join her husband again. I stepped out just as silently as I had come in. To do this job, you learn to compartmentalize. I take walks.
The first half of the shift had otherwise gone without surprise. The ICU overhead lights were turned off, televisions were muted, and conversations were hushed. I retreated to a computer to catch up on charting. That’s when I heard the faintest sound of a trumpet.
I traced the music to bed 8 and pulled back the curtain. Intubated, sedated, no worse than he was one night ago but also no better, a middle-aged man was propped almost upright in his bed, the fluorescent room lights illuminating his face. He had three drips running. Four, if you count the antibiotic that had just finished. His eyes were puffy and his beard was bristly and unkempt. His nurse, circling the bed, reminded me that he was clean-shaven on arrival.
It was surreal. I was transported for a brief moment to a barbershop not unlike the ones I used to visit.
A white towel draped the nurse’s shoulder, one hand stretching the man’s face, his other lathering him gently with lotion. A blue twin blade razor lay prepared on the supply cart along the wall. The nurse worked diligently, casually stealing glances at the monitor before just as quickly turning back to his craft.
I watched silently for the next few minutes, not entirely convinced this was happening. On the list of pressing concerns in critical care medicine, a patient’s personal hygiene usually doesn’t break the top five. Important as it is, it is not realistically something we have the time or resources to get to. I met a patient at the very beginning of intern year who was in the third month of his admission and I remember my bewilderment at the length of his fingernails. I looked everywhere for a nail clipper that day but couldn’t find one.
The barbershop in bed 8 brought back that sense of bewilderment. I interrupted the nurse who by now had begun shaving the man and thanked him for caring about the small things. Then I asked why.
Today’s his big day, he said with an inviting smile, and dove back into the man’s cheek. The smooth melody gave way to a deep bass, masked only by the scrape of the razor on the man’s face.
I looked at the clock before stepping out. It was now a little before one-thirty in the morning. In a few minutes, the man will be patted dry and dressed in a fresh hospital gown. His bed will be flattened, his bandages will be exchanged for new ones, and he will be tucked in with a clean blanket. A few hours after that, his family will gather around him. His monitor will be muted and then, with a solemn head nod from his wife, it will be turned off.
I was sitting at a computer mulling over this display of humanness when I saw the lights go out in bed 8. The barbershop was now closed. I stood up — I had to take a walk.