President’s Message - The Dash

2014 - 2 April – Patient- and Family-Centered Care
J. Christopher Farmer, MD, FCCM
SCCM President J. Christopher Farmer, MD, FCCM, discusses the noble motivator that drives critical care practitioners.


Genealogy is humbling. Everyone dies. But what is remembered after our deaths? We’d like to believe our legacies live on, but at some point, each of us is distilled into an entry on a simple chart: date of birth - date of death. Separating these dates is a dash, nothing more. That dash represents the whole of our existence:  love, loss, success, failure, aspirations, dreams, sacrifice, happiness, sorrow, pain, joy, wisdom, regret, fatigue, tenacity. There are no pictures of our houses, no CVs, titles, plaques, diplomas, or completed call schedules. It’s just a dash. This is not a revelation; each of us understands mortality all too well. Working in critical care provides a looming reminder that death is never far away ... from anyone.

We repeat these inevitabilities to each other. We remind each other to “savor.” And, we try to elevate the existence of the person in the intensive care unit (ICU) bed to more than a dash. We avoid phrases like “bed 12,” or “the patient on ECMO.” When families place photographs in the room, we make efforts to pause, to look, to absorb their content. Happier times, surrounded by family. A different appearance, sometimes shockingly so. Freedom from pain. Bluer skies. But eventually, even those patients who leave the ICU and return to their families, even the patient in bed 12 ... each becomes a dash.

Studying a genealogy chart, a future family member comments, “This guy, J.C. Farmer, was an ICU doctor, whatever that was. Have you actually seen a real stethoscope? It’s amazing what they tried to do with those things.” To that future family member, I am a dash. A novelty, a punctuation of time long passed.

Ouch! Really? That’s depressing.

So, what’s the point? Why do what we do?

The due date for these few paragraphs was Valentine’s Day. The day fits this topic. It helps me answer these questions for myself. Simply, we do what we do for love. Sometime in the future, our lives become a dash. But not our motives. Not our commitment. Not our love. The work that we each contribute in our ICUs and to our patients is noble and good. For me, genealogy is a tangible reminder to focus on what is truly important. To pause and to live with enduring love for others. This love lives on in the hearts and souls of our patients and their families, our families, our colleagues, and those who follow us on the genealogy chart.