After being re-intubated and septic, a patient developed ischemic gut following the first heart surgery. Josh was present as the general surgery team told the patient's daughter that she wasn't a candidate for another surgery. Josh had several long conversations with the daughter as she made the decision to place her mom on comfort care. The patient survived several days after they stopped medications and turned off the vent. During this time the patient had a birthday, and Josh bought the daughter a cake and spent time with them that day (even on his off days). He played the patient's favorite music on his phone and brought food to the daughter during the 3 - 4 days her mother was in our care.