Please, sit down. I don't know how to say this, but I'm afraid your father didn't make it. I'm so sorry. I know nothing can make this tragic news easier to hear, but if it's any consolation, we did practically everything we could for him.

With a few relatively tiny exceptions, there was nothing else we could have done.

Your father—or grandfather, was he? Whatever, anyway, that guy's wounds were extensive. His spleen ruptured en route to the hospital, and his internal bleeding was a real hassle to control. Dr. Juzwiak and I operated for almost three hours, on and off, and although we exhausted a good, I'd say, 75 percent of the options we had, the damage to his heart was simply too severe.

I'm sorry to be the one to tell you this. But there was only so much that his insurance plan covered.

To be fair, we didn't have a very strong chance going in. Sure, there were some radical new procedures we could have tried, but they're really expensive, and you could certainly never have afforded them. Plus, they're extremely complicated and would have taken just hours and hours to perform correctly. Believe me, you have no idea. But I assure you, we did everything we could, within reason, to try and at least make an effort to save your…male relative's life.

We opened his chest up, rooted around for what seemed like forever, and tried pretty damn hard to restart his heart. The details are technical, but trust me when I say it was a real mess in there. I washed my hands before and everything. The whole bit.

Well, almost the whole bit. I had the general idea, anyway.

Given your grandfather's age, overall state of health, limited medical coverage, the fact that it was almost 5 p.m. on a Friday, and that hand cramp I got midway through, the odds were stacked against him. He was in bad shape. Nonetheless, from the moment I woke up from my afternoon nap until the minute we decided to call it a day, Dr. Juzwiak and I gave it the ol' college try—you can be sure of that.

He's in a better place now, really. This hospital is terribly overcrowded, there's no AC, and I feel like I see a different sick guy walk in here every 15 minutes. It kind of sucks.

Giving news like this is probably one of the hardest parts of my job, which is why I generally make my interns to it. I can see the pain in your faces. I know you're angry; I'm angry, too. I just wasted three hours of my life on a long-shot patient and I come all the way down here only to discover that the damn vending machine's out of Sprite Zero again.

Hopefully, in time, you and your family will find some solace in the fact that we gave it a good, solid go. I mean, we didn't get carried away or anything, but we definitely did a majority of the things we could have done for your father at the end there. Think of it this way: Even if we had saved him, he was pretty old to begin with, so he probably would have died of something before too much longer, whether we killed ourselves operating on him or not.

All we can do now is pray that the insurance company agrees to pay for what we did manage to do for him.

Please…don't feel the need to say anything now. You've just had a terrible shock. The death of a loved one is never easy. Right now, the best thing for you to do is go down to the accounts department, fill out and sign a bunch of forms, write a few checks, thank us for all our hard work, and then go home and get some rest.

I'm very nearly sorry for your loss.