This blog entry is a continuation of the entry “Difficult Discussions are More Difficult When You Can’t Have Them.” On my previous post I talked about Tom and I finished with “may he rest in peace.” Actually I wrote that because I didn’t think I was going to write about him anymore. Well, Mr. Tom actually died this morning before I could make it to the hospital. As previously stated, he was started on comfort measures and he continued to decline through the weekend. I finally started to round at about 10am and made it to the unit. He was transferred to a new floor overnight and I looked on the board to see which room he was in. After I located his name and said it under my breath, a voice from behind me stated “he died.” Really, I just got a phone call a few hours earlier stating he transferred to this unit. “He died at 0720,” stated the nurse. I always return with the same question hoping I hear the right answer. “Was he comfortable?” I asked, “Yes”…exhale, right answer! I asked if his body was still present and they told me he was still in his room. As I stood over his pale body, I reflected on how peaceful he looked compared to what he looked like in the ICU on the day of my initial consult. My thoughts went to his niece who decided to make the difficult decision to be his advocate. I stood for several minutes in silent reserve, said a prayer and left. May Tom rest in peace.