Critical care nurse Crystal Diggs can’t help but think of Jello when she looks at her patient’s chart. The kidneys of the patient in room D 210 are rebelling because they are trying to do the equivalent of sieving Jello through a coffee filter. But instead of cherry-red or lime-green gelatin, his kidneys are straining to filter myoglobins, large molecules released into the bloodstream when muscle fibers begin to break down— a process called rhabdomyolysis.

Often, as an ophthalmologist, my father has to deliver bad news. He tells people what’s wrong with their eyes and hands them some words to hold onto: Astigmatism, cataracts, glaucoma, macular degeneration.

“You look so much like your mom,” says the starched, very pregnant nurse at the rehab unit where Mom has been sent to recover from her hip surgery, “only younger.”My pulse skips whenever someone says this.

On the Sunday night after my overdose, when I was certain no one would be there to answer, I called my internist’s office. I styled my voice to sound casual and perky, evoking a 1950s receptionist.

“Medic! Medic!” The screams came from above me. I ran up the trail and into the woods. Red and white smoke billowed across the ground, obscuring everything.

“It’s not that bad.” Mr. Kelly smiled. “I’m not even hurting now.” He was a forty-two-year-old house painter who’d been having intermittent chest pain for two days. Three wires ran from under his patient gown to the monitor in the corner, where a fine green line bounced with every beat of his heart.

Twenty minutes before Dr. John Riley stepped back into the bronchoscopy suite of University Hospital and uttered the word “stop,” the day seemed promising.

The stories in Silence Kills might appear to be about medicine. My sense when I was done reading them was that they were really about life, about the very human urge to extend life and relieve suffering, and about how easily in trying to make things better we can make things worse.

When the Jewish Healthcare Foundation commissioned this project with Creative Nonfiction, we had something specific in mind. We wanted to build on a study by the American Association of Critical Care Nurses, also called Silence Kills, that highlights how health care professionals avoid conversations crucial to good patient care.

This is Creative Nonfiction‘s third issue devoted to health care. The first, issue no. 11, A View from the Divide, dealt generally with science, biology, and psychology. It is still in print and has been repeatedly acknowledged by critics and teachers for the fine writing it contains.Then,