he has no wrinkles.

that's the thing about the ICU - the people there are always old, gray, wrinkled. they all have diabetes and hypertension and take 10 prescriptions twice a day, and more importantly, they've all lived their lives. maybe not lives they are proud of - clean living earns you less of a chance of an ICU bed - but they've lived, had children, watched them grow and get married and have babies of their own. somehow, the wrinkled people don't make me sad. our bodies were not meant to live forever. that part of us was made to pass away.

this man, though, has no wrinkles. he's only 35 or so. he's the kind of guy who watches the superbowl with his buddies and some yuengling, and then goes home and has sex with his wife to celebrate a steeler victory. and that's exactly what happened, except that this time he stopped, oddly, and fell to one side. they layed there in bed for a while, wondering if it was all the excitement, probably wondering if it was just some weird sexual reaction that was leaving him numb and sweating and dizzy. several hours later, in the hospital's ER, the picture of his brain told us exactly what had happened. a tiny little blood clot had silently formed in his heart and got pumped into his brain. got stuck, stuck in the wrong place. now, his brain was thick with blood and swelling. parts of it had gone without blood flow (and oxygen) for far too long. within 24 hours his brain swelled so much that it had herniated through the small opening the skull has with the spine. since the emergency surgery to decompress the pressure, his brain is now covered by a small flap of scalp - the bone, i am told, is in a refrigerator somewhere, waiting for the swelling to subside before it is replaced on his head.

every day, i visit this man. i pry open his eyes, shine a light in each one. i listen to his heart beating. i squeeze his hands and pinch his legs. i look for a sign that he'll be anything like he was 2 weeks ago. i hope, i hope so very badly for him, but i know too much to spread that hope to his wife. i've seen the mush that one side of his brain has become. the dominant side, as luck or God would have it, has died. our team of doctors always stands hushed by his bedside. 'he should have died,' they whisper. it would have been better that way. i wonder whether his wife will someday agree, or if she'll cherish the years she'll have to care for the body he's left behind.

it's dark, and i'm sorry, but the blunt transience of life always hits me at the end of the day in the ICU. the unpredictability of it all. one day you can be so full of life, and then a moment passes and the course forever after is drastically, permanently altered. i sit in the middle of my oriental rug, almost married, almost a doctor, almost ready to have sex (!!!) myself. i sit here planning all these dreams of tomorrow, of places i'll live, children i'll have, wrinkles i'll earn. i worry about the details sometimes (often). rarely do i remember the other possibilities - that there may be no details. that there may be no david. that there may be no me, and that while the dates of expiration on each of our bodies are hidden to us, that there are, in fact, expiration dates.

the first day i met this man, i cried. every day since then, i've been so thankful that we met. the fact is that not all of us will live long enough to wrinkle. i wonder if he made his unwrinkled days count. i wonder if he counted them at all.