“The day it all changed” is rarely one’s wedding day or graduation or the birth of a child. Instead, the moment that our energies shift from potential to kinetic typically coincide with one pervasive theme in mind: we hit rock bottom. What that means can vary from person to person — no two rock bottoms are the same — but I have come to understand that life’s joyous occasions rarely transform us. Rather, when we are chipped and chiseled, it is life’s darkest moments that take shape. Either they carve the stones of our psyche into a masterpiece, or turn determination into dust.

I am an ICU nurse. When I swipe in at seven-o-clock in the morning, I deliver unto myself a stark and stoic reminder that, no matter what circumstances may unravel over the next thirteen hours, I get to go home at the end of the day. The same cannot always be said for the patients charged with my care — fighting in the most visceral and basic way for their lives, some bear witness to “rock bottom” in its purest form. Sometimes, every literal breath is a battle. Others, time passes while standing still. Often it is a battle of the mind and body and spirit against the ticking clock. Every drop of blood; every ounce of medication; every iota of chemistry within their failing systems remain dependent on the complex crossroads between science and something greater. I know rock bottom. I see rock bottom. In many ways, I help to heal rock bottom but some days — in the very work I do — I perpetuate it all the same.

I have stood in the corner when news has been delivered of death and disfigurement. I have been present for conversations — the most gut-wrenching and somber and surreal variety — between physicians who have done all they could, and families who can’t bear to let go. I have seen the day it all changed for patient’s receiving a call for an organ transplant — and the bittersweet sentiment that someone else had to die for their own chance to live. I have watched the day it all changed in slow motion — the gasp of breath; the pained look of confusion; the hot, red stream of tears; and the blood-curdling scream — of a wife blindsided by the devastating loss of her one true soul mate. I have held the hand of a barely adult child, plagued by the responsibility of making the decision to withdraw life support of the strong and stubborn matriarch. I watched her world shatter as she collapsed literally and figuratively onto the sterile ICU bed: her rock bottom consisting of white sheets and salty wet kisses on a cold, lifeless hand. I have pushed drugs and shocked hearts and squeezed bags of blood, desperate to convert the erratic circumstances like an EKG rhythm…from a series of ups and downs to a new normal worth living. I have helped rock bottom pick its fragile and weeping body off of the cold, hard floor and elevate it — if by only a fraction — from where it once lay before.

I am an ICU nurse. I have lived my own “day it all changed.” I have pounded, frail and terrified, my fists upon the stony surface. I have questioned the existence of God. I have cursed the complexity of medicine. I have lost faith and lived every emotion before feeling nothing at all. I have been smacked by reality; I have been cracked by the circumstances; but thankfully, the scars of my schisms have been polished and buffed. The fear and the doubt and the terror have been shaped into something richer…deeper…pain repurposed into some newly chosen path. I can remember the day it all changed as if it was yesterday. I can feel rock bottom deep within my marble bones. And every time that I hold a hand or wipe a tear or watch a flat line scroll across a bedside monitor: I will remember that, for someone else, this will be the day it all changed, too. Share with me your rock bottom. Keep me privy of the day it all changed. I will not save you from yourself. But cloaked within my arms, I will gently lay you upon your back; tilt your head up toward the sky; and share the view with you.

Originally published at medium.com