In these cases the universe remains deafeningly silent. Indeed, there are times when my efforts seem meaningless, especially when I cannot get a good result for my patient or if I cannot get the patient’s family to understand that there will be no meaningful result for their loved one. He insists we need to make a leap of faith and place our trust in God or conclude that life has no meaning, thereby allowing ourselves no alternative but to commit suicide (because life is meaningless). Camus claims we will never find the meaning we seek. I truly try to elude the feelings of meaninglessness that his dialogues address. Upon reexamination of this text I came away a little disturbed because I could see parallels in Camus’s arguments that apply to my practice of critical care medicine, especially in times of despair. 2 I recalled that its content struck a bell somewhere in my remote memory in regard to my current situation. 1 So I made a note to myself to locate an old text that I had read in my youth and to reread it: The Myth of Sisyphus by Albert Camus.

I realized that as an intensivist I am subject to burnout.

In effect, an intensivist cannot live anywhere but in the present, and in this “present” I contemplate the effectiveness of my efforts, and at times the futility of these efforts that I struggle with on behalf of my patients and their families. At the end of the day I hope that things have gone better than the day before. I formulate treatment plans with foresight, but I know that setbacks occur in the care of such patients. I try to get my critically ill patients through the day. Physicians who practice critical care medicine (intensivists) are at the forefront of treatments that confront the complicated, the futile, the end of life, hopefulness (and hopelessness), and, at times, a search for the meaning of such efforts. At times I can put it off for days sometimes I can help put it off for decades.

I spend most of the hours of my days trying to delay or avoid the inevitable on behalf of my patients in the intensive care unit (ICU).