Dear Nathan,
I hit my breaking point today at work. Around the holiday season, the ER always gets swamped with car pile ups and emergency procedures. This means my schedule can go from a slow day in the pit cleaning scut, or fast-paced surgeries across multiple ORs. My thoughts run rampant and I must stay on my game at all times on days like this. One particular patient set me off, but not because of something he did. It was his health condition.
His name was Colin Walsh, and he was the same age as you were. When he came into the ER, a swarm of paramedics gathered around him, forcing tubes and compressing oxygen into his weak lungs. As doctors wheeled him into the nearest open bed, nurses began to recite his chart and the degree of his wounds.
“Male. Twenty-eight years old. Multiple lacerations on the stomach, chest, and legs,” a nurse delivered. “His arm is fractured in multiple places, and his clavicle is broken. There’s great deal of swelling in the lower abdomen.”
My body froze. I couldn’t breathe for a view seconds, and I dropped the scalpel I was using to drain the blood from my patient’s leg. My brain went numb, my hands shook. I felt so helpless. Colin Walsh’s injures were the same as the ones on your hospital report, and I was treating them.
The head ER surgeon lightly pushed me back from the table. “If you’re not going to help, step back,” he quietly told me.
He was right; I was helpless. My brain stopped functioning like a first-year intern, and it was embarrassing. Because of my inability to survive with you gone, I forgot how to be a doctor. Instead of treating the patient like I was trained to do, I watched from the viewing window like a family member. Within minutes, his heart rate dropped, blood filled his stomach, and he began to seize on the table. Colin Walsh’s face morphed into yours; it was like watching you die in real time, except it wasn’t you. I had to rub my eyes multiple times before the image of you bleeding out on the table cleared from my mind.
I made a fast break for the lounge room to collect my belongings so I could go home. My shift ended in five minutes, and I doubted that I would be much help if anyone needed me. I punched out, placed my card in the holder, and made a mad dash out the front doors of the clinic. When I reached my car, I began sobbing again. I tried to wipe the tears from my face, but they just kept coming. Who knew a person could cry so much? I didn’t think I had that much water in my body. Maybe I became dehydrated, because I was light-headed and my chest hurt after that. I slammed my hands on the steering wheel, screamed into my sweatshirt, and even squeezed my fists against my thighs, but nothing helped. The image of you lying dead on that table wouldn’t get out of my head.
So, I drove. I drove so far that my gas light began to blink. I hurried to the nearest gas station, filled up my tank, and stopped inside to grab a quick snack. When I got back in my car, I texted Mom and asked her where your grave was located. She replied to me within seconds, and I felt bad that I texted her at such a late hour, especially about you. I followed the directions she sent to me, ignoring the series of questions which followed,  and drove to the hills of Allegheny Cemetery.
I parked my car near the front entrance instead of driving to the section that you’re in because I needed some fresh air. The cold breeze bit at my cheeks and froze the tears that soaked the skin below the bags of my eyes. In about a half hours time, I found your headstone. This was the first time I visited. It’s a white, marble cross with your name engraved at the base, along with the year you were born and the year you died. The headstone itself is nice, but it doesn’t reflect who you are. Next to you is Grandpappy and Grandma Russo. I think it’s nice that you’re buried next to them so at least you have some company.
As I sat down in front of your grave, I placed a package of Swedish Fish next to it and the necklace you bought me when we went to Amsterdam together.
“Two of your favorite things,” I whispered. I opened my Sour Patch Kids and popped one in my mouth.
I began to tell you about what life has been like without you, how Mom and Dad have held up, and my thoughts on whether I want to travel again even though you won’t be here to share the adventures with me. If I had a dollar for every time I said the words ‘I’m sorry’ while I sat there and talked to you, I could pay Mom back for that time we broke her vintage vase from China.
In the time I cried, laughed, and ate my feelings away with the snacks I brought, I started to feel a little better. I needed to come see you for reasons that are very obvious, many of which I do not wish to admit.
Although I repeated it many times, I truly am sorry. I know that means absolutely nothing now, and I’m way too late saying it. You will never know how repulsive I feel towards the way I handled your death and what led up to it. Over two weeks ago, I would have let that completely destroy me, but now, I’m learning to cope.
And I think that means this is goodbye. I love you.
          Your sister,
          Josephine