Just breathe.

Eighteen years ago, I was a brand new cardiologist starting out in New London. I was a bit cocky, right out of fellowship. I was doing a pretty routine cardiac catheterization at the time on someone, everything going smoothly, when Karen, the amazing unsung hero-cathlab tech who has saved countless lives through her astute care, shouted “VFIB!!”

Now, “VFIB” is very, very bad and basically means cardiac arrest. Suddenly, I felt very hot very fast. It had been the first time this happened when I was “in charge.” I couldn’t see because my safety glasses fogged up from the breath coming from my hyperventilating. I knew how to fix the VFIB — which we eventually did — but first I had to see, and in order to do that, I had to just slow down and breathe.

A few years ago, I started kick boxing for exercise. What a blast. The first time I sparred, I was paired first with a guy my age for a two-minute round. We thumped at each other clumsily for a bit, both a bit uncoordinated, then took a 30-second break.

I turned to my new spar partner, who was this lanky young woman in her late teens/early 20s. My first thought was that there was no way I could punch a cute kid, much less a girl. So I danced around and jabbed. And jabbed. And jabbed. Apparently, each jab left an opening so that after the third jab, ka-PLOW, she (who was, unbeknownst to me, an accomplished martial artist) crossed right into my nose and I saw stars.

“You OK?” she asked.

“Yep,” I grunted.

Then I danced some more and switched to a half-hearted cross punch. Once. Twice. Three times, then POW, the cute little skinny girl left-hooked me into the ribs, lifting me off the mat, and now all I wanted was blood. Except. I. Could. Not. Breathe. At. All. Luckily, the bell rang. My pride, and the wind, was restored, and I relearned how to breathe.

The nature of medicine is that we occasionally do high-risk procedures on people who are dying, knowing that the odds are stacked against us but hoping that we may find something that will lead to, if not a cure, well, then maybe another day of laughter, a game of cards with the grandchildren, a loving caress. One more day. One more week. One more month. One more story. One more "I love you." One more goofy joke.

And so, in the middle of writing this, I had to do just such a procedure in just such a tough case. It was clear that the odds were very much against her. And while I wish with all my heart I could say it went well, it did not.

One of the hardest things for me is to walk into a room where the family member waits to tell them the bad news that their loved one is dead. Each time, I feel as if there is no air, as if I have no right to breathe. When he looked at me, I could tell he had been holding his own breath, but seeing me, he knew right away. He took my hand, lowered his head, thanked me, and then he said, prayerfully, “She is in heaven.” And then, before the torrent of grief and arrangements and paperwork, we looked at each other for a moment, paused, and we both just breathed.