The sound I remember most from the early days of Covid-19 is not the alarms. It was the silence between them. Intensive care units became Covid wards. Monitors glowed in dark rooms while ventilators pushed air into failing lungs. Nurses, shrouded in protective gear, moved quietly. Families were absent—barred from being with loved ones in their final hours. One night at 3 am, I stood by a patient whose oxygen levels were steadily falling. Outside the room, another patient crashed. Down the hall, a third awaited intubation. For months, this was every night. For 715 consecutive days, I worked in that environment without taking a single day off. In moments like that, medicine becomes very simple. There are no politics in an ICU at 3 am. There is only a physician and a patient, and the responsibility to do everything possible to keep that patient alive. That philosophy has guided physicians for generations. It is the foundation of clinical medicine: when a patient is dying, you explore every reasonable option that might help. Yet during Covid, something extraordinary happened. What made the shift so jarring was not simply the presence of disagreement. Physicians have always disagreed. In fact, disagreement is the normal language of medicine. […]