Making Room for the Sacred: An ICU Physician's Perspective

Dr. Adjoa Boateng Evans is an intensive care physician and anesthesiologist whose calling has taught her that medicine’s deepest work often happens beyond charts, tubes, and monitors.

In the ICU, bravery is not always found in the machinery that sustains or stalls breath or in the procedures that slow decline. It often lies in the quieter acts. Moments of connection that require us, as physicians, to lean into vulnerability rather than retreat behind technical skill and confusing jargon. For me, this is the radical bravery of end-of-life care: the courage to connect with patients and families at their most fragile, when words weigh heavy and silence feels safer.

One of the simplest, yet most profound ways I connect with patients is through food. I often notice the small containers tucked into corners of ICU rooms: bowls of soup, a half-eaten sandwich, fruit wrapped in plastic. I ask about them. “Who brought this? Did you get a chance to taste it?” Food is a universal chord, it carries memory, identity, and belonging. For patients battling critical illness, appetites are often decimated by disease and meals reduced to a cruel reminder of what the body has lost. When we round on patients we have long conversations about their nutritional status, intake and various routes to get enough calories.

Yet when I ask about food, something shifts. A woman’s eyes might brighten as she recalls the chapati her daughter makes every Sunday. A man might chuckle, remembering his weakness for French fries, even when his blood pressure says otherwise, or an elderly woman professing to make the best pound cake in all of North Carolina. In these moments, food ceases to be about calories or nourishment. It becomes a bridge back to personhood, to joy, to shared humanity. It is a small act, but it allows me to meet individuals not just as patients in bed 12 or bed 19, but as people with stories and histories and desires that reach beyond the ICU.

With families, the question that most often unlocks connection is this: “Tell me about your loved one before they got sick.” The ICU is a place where identity is obscured. Tubes, drains, monitors, and machines flatten individuality into a cacophony of medical data. When we gather families for meetings to make difficult decisions about resuscitation or hospice, the body language is tense, the air tighter. Breath is held, waiting for our updates. But when I ask that question, the atmosphere changes. Faces soften. Phones come out, showing us videos of birthdays, photos of weddings and playing golf, stories of fishing trips or dancing to favorite songs. They tell us, “my brother is a fighter!” We reassure that he is currently fighting the biggest fight of his life. I have listened to a daughter describe her father’s gregarious laugh that filled every room and watched a husband beam as he showed me pictures of the garden his wife planted each spring. The patient, once defined by ventilator settings and vital signs, is resurrected back to personhood through memories. These stories help me care for them more fully, and they remind families that love can remain whole even when health is fractured.

These gestures, asking about food, asking about a favorite vacation or military deployment, may seem small, but they take courage. It is easier to remain stoic, clinical, and guarded from the emotional weight it takes to shift from fielding data to fielding questions like, “will my mother survive?”. Yet connection demands risk: the risk of feeling, of grieving alongside my fellow mankind and ultimately allowing tears to erupt in the car ride home reminding me that I am fulfilling my calling. In these encounters, I am reminded that healing extends beyond medicine. Faith often leads me to the bedside, where I take a trembling hand into my own and offer prayer. In those moments, the boundaries between doctor and patient dissolve, and what remains for me is our shared vulnerability.

Radical bravery in end-of-life care is not about avoiding fear or pain. It is about daring to connect in the midst of them. It is about seeing, hearing, and honoring the fullness of lives entrusted to us, even when the return of health is beyond our grasp.