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This is part of a regular series of posts about bearing witness to death in the ICU after the withdrawal for mechanical ventilation. For more background information, read this first. As always, names and identifying information have been changed.

Marie had short, thinning white hair and a few age-spots and laugh lines on her otherwise porcelain face. Her fingernails were painted blue by her granddaughter. The hospital gown swam on her slight frame. Her husband of 65 years, Phil, was quiet. He was reliant on his cane and his hunched back made him unsteady when he stood for more than a few minutes.

Marie & Phil’s two daughters watched their father nervously. “We’re so worried about him,” they had confided in me, “he won’t know what to do. He’s been in denial about all of this.”

All is silent while the respiratory technician comes in and removes Marie’s breathing tube.  Then there is a scuffle of moving and arranging chairs. Phil is placed in a high-backed recliner next to his wife’s bed. He looks down at the floor. The daughters hold each other and accept the tissues I offer to them. Phil’s nurse  moves around, spending a few minutes holding up one wall before forsaking it for the next.

Wordless moments pass and all the women in the room look at Phil with concern while he continues to cast his glance downward.  As if sensing everyone’s gaze, he takes his cue and slowly attempts to stand up. He rejects his cane that is quickly retrieved from a corner, favoring Marie’s bed rails instead. He leans forward gingerly and gives her a kiss on her forehead as she continues to breathe her last breaths. He moves his lips to her ear and begins to softly and sweetly serenade her.

“I love you, yes I do. I love you, yes I do.”

He sings this simple verse for at least twenty minutes. Marie seems peaceful and content as her husband’s baritone voice washes over her. Her and Phil’s eyes are the only dry ones in the room.

He lowers himself back into his seat and switches to the chorus of “Old McDonald Had a Farm.” One of the daughter’s explains to me that Marie often sang that to her grandchildren when she babysat.

There has never been so much tenderness in “Ee-i-ee-i-o” before and doubt there ever will be since.