Since i last saw you your heart has beat 20 million times. Your lungs have taken 5 million breaths. Your eyes have been open for thousands of hours.

When we went into your room every morning on rounds nobody talked much. There wasn't much to say. Not much changed from day to day. Yyou weren't getting better but you weren't getting worse. We watched your heart beating on the monitor over your left shoulder. We listened to the ventilator humming in the background, watched your chest rise and fall rhythmically with it.

Your family asked about the plan every day as we left the pediatric ICU. Visitors weren't allowed in the unit. Your dad wanted to know specific lab values, how your sodium trended overnight, how high your lactate was, if you were still on pressers. Your mom just wanted to know if you'd opened your eyes yet. Your little sister asked if she'd ever be able to hug her older brother again.

A few days after your admission i saw your parents meeting with the organ donation team. They'd had the conversation we'd all been thinking about since you were first admitted to the hospital. It was the direction we knew things were going in but there was a certain finality seeing them sitting there after being stuck in limbo for so long. Your parents were the ones to request the meeting. The medical team hadn't brought it up yet. They asked about who is eligible to become a donor, they asked if the gunshot wound would prevent you from becoming a donor, they asked about what organs you'd be able to donate, and they asked if they would ever be able to meet the recipients.

The organ procurement happened a couple days later and was successful. your heart, both lungs, your corneas, as well as your liver, kidneys, and small intestines have new homes.

Since i last saw you your heart has beat 20 million times, your lungs have taken 5 million breaths, your eyes have been open for thousands of hours. But you will never feel your heart beat against your chest again. You will never catch your breath when you step outside and breathe in cold winter's air. You'll never see another sunset.

In medicine, we are far too familiar with stories that don't have happy endings - where the ends don't justify the means. We put everything we have on the table and still get beat. Sometimes we do everything right and we still lose. Other times there's nothing left to do because the game is already over. We expect stories that don't have happy endings as part of the game.

Since i last saw you, I've been thinking about the silver lining in your story. Even though it was the worst day of your parents lives, other families got the call that after months or years of waiting their kid was finally going to get a new heart, a new lung a new kidney. By choosing in that time of immeasurable grief and heartbreak to share your heart with strangers, they kept your story going. Your story did not end that day. Every one of those 20 million heartbeats is physical evidence of that. I can't tell you that your story had a happy ending. I can't tell you that since i last saw you we've put a stop to gun violence because since I last saw you almost 900 other children have been killed by guns in the US. I can't tell you that we've finally woken up to the fact that even living in a home with a gun triples one's risk of dying by one and that those who buy firearms for safety are often doing more harm than good. Because since I last saw you five million more homes have guns in them.

I can't tell you that your story had a happy ending but i can tell you that your story isn't over yet.