I'm feeling glum my patient from last week has come back to theatre and it's not looking good for him. Surgeons have worked so hard and look so tired but we're not helping. Sometimes we just don't know when to draw the line. The patient was never going to survive for any length of time and now it looks like they may never leave ITU, if they survive this surgery. There's no win here for the patient their family or for us. It's all just sad. I wouldn't choose this as a way to die. Please people have this conversation with your family!