I Still Hear His Silence

It was 2009, and I was working for a neurosurgeon, covering clinic as his PA. It had been a long, grueling day—one of those stacked afternoons where you're just trying to keep your head above water. We had just finished when the call came in from the ER: STAT consult. Cervical trauma. Young male. Diving accident.

The details would unfold quickly and painfully.

A 21-year-old boy—because at that age, they're still boys in so many ways—had dove headfirst into unknown water and struck something hidden beneath the surface. The impact severed his spinal cord high in the neck. He was now a ventilator-dependent quadriplegic. No sensation. No movement. No future, at least not in the way most of us define one.

His history was complicated. Raised by his grandmother. His parents were alive but estranged, completely absent from his life. A few arrests as a teen. A turbulent path. But recently, he had been trying to pull himself together. Trying to make something of the wreckage.

And then—this.

When the neurosurgeon reached his grandmother, she said flatly, “He's 21. He can make his own decisions. I won’t be coming.” His parents were unreachable.

He was alone. In every sense of the word.

And in that loneliness, he made a choice.

He told the surgeon he didn’t want any intervention. He didn’t want to live as a shell of his former self, attached to machines, no chance of recovery. He said the world would be better off without him. That his life hadn’t amounted to anything good.

And so... he died.  Alone.

No one held his hand. No one whispered words of comfort. No one stroked his hair or said, “You matter.” He simply... left.

I found out the next day, and my heart ruptured.

I wept in the breakroom. I wept at the thought of my own son, who was the same age. I wept because I couldn't shake the image of this boy—barely a man—slipping away without a witness.

There was a Carly Simon song playing on the radio around that time. It haunted me then, and it still does now. The first verse echoes him in ways that language alone cannot:

“Oh my boy, what have you done? 
Did you go out surfing on a frozen sea? 
Did you scare the livin' daylights out of me? 
Did you go too far to drive away the demons? 
Did you go too far to know what love really means?” (From Hold on to Your Heart, Carly Simon)

I’ve carried his story like a stone in my chest all these years. Not because I failed him. Not because anyone did anything “wrong.”  But because something sacred in his death was missing, and I still don’t know what to do with that absence.

There was no hand to hold. No voice to say “you mattered.” No one to sit beside him in the moment when his soul left his body and maybe that’s why this story doesn’t have a takeaway.

Maybe it’s not a lesson, but a lament.

A reminder that for all our knowledge, all our procedures, all our rounds and consults and clinical notes—we are still just human beings trying to catch each other as we fall.

I don’t know what that boy needed in his final moments.  But I know what I needed: for someone who loved him to have been there.   Someone to say, “You don’t have to leave this world unseen.”

I still see him.  I still hear his silence.

And maybe that is the only truth I can offer here:

That some stories don’t resolve.  Some stories just live in us, shaping how we hold the next patient, the next sorrow, the next soul who wonders if they matter.  This one taught me to stay close, even when there’s nothing left to fix.

Especially then.