Held in Prayer with Nikki Mittal, DO
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What is the main topic discussed in this episode?
Hey everyone, I hope you're having a wonderful spring. In the spirit of renewal, I wanted to share something new that we've been working on. It's called The Nocturnous Plus, our new subscriber-only feed. With a subscription, you'll get access to the Nocturnous After Hours, a monthly bonus series featuring original conversations between me and our executive producer Ali Block. Along with discounts on our new merch and access to all of our episodes in one place. To give you a taste of what it's like, here's a clip from our very first After Hours episode, where Allie and I talk about the ups and downs of being the doctors in our own families.
It was my first experience where a healthcare provider was sort of using lines on me that I knew. So the biggest thing was he was trying to transfer my dad out of the neuro ICU. And I was trying to argue that he was not ready to go to the floor. And I'm sure you're very familiar with this line. This ICU doc said what we say to patients in the hospital all the time, which is, you know, it's really much safer for your dad to be somewhere else. He could get an infection, he could get a DVT. And I was just like, don't pull that with me. I know those lines.
That's the Nocturnous After Hours. We're really excited to see how the series evolves. It's been really fun so far and would love to hear your ideas, questions, and suggestions along the way. If you want to join us in this new corner of our community, take a visit to thenocturnist.org slash plus. Subscriptions start at just ten dollars a month. And now on to today's episode.
At the Nocturnus, we are careful to ensure that all stories comply with healthcare privacy laws. Details may have been changed to ensure patient confidentiality. All views expressed are those of the person speaking and not their employer.
This is The Nocturnus and I'm Emily Silverman. Today's episode features Dr. Nikki Mittal, a pulmonary and critical care physician. Nikki tells a story from the ICU about caring for a patient who had suffered a devastating brain injury after cardiac arrest, and a family preparing to withdraw life support. At the time, Nikki herself was going through a painful period in her personal life. And after one difficult interaction with the patient's wife, she left the room worried that she had failed in the one part of her job that matters most. But on the day the family gathered to say goodbye, something unexpected happened. Instead of asking Nikki for guidance or reassurance, the family asked if they could pray for her.
Nikki originally performed the story at a live nocturnist satellite storytelling event, produced by the San Bernardino chapter of the California Academy of Family Physicians, with support from the California Healthcare Foundation. In my conversation with Nikki, we talk about the realities of working in the ICU, how physicians navigate conversations about death and dying, and the moments when the usual direction of care shifts. But first, here's a clip from Nikki's live story.
So I'm standing there facing this woman. And she's my height. I'm only five foot two. We start holding hands. And she starts praying. She's the you know, God sent you here and and God tells me you're a very smart person, you're a smart doctor, and you're supposed to be here to help these patients. And as she starts chanting and praying. Everyone in the room starts doing their own chanting and praying and it's not in unison. Everyone is just speaking their own words. And you could kind of feel this whole energy starting to rise up in the room. And I'm trying not to cry. I'm trying to just be present and put out all of my good energy into the universe for this family to have some peace with this moment. And as she keeps praying, all of the other kind of voices in the room drown out, and all I hear is this woman holding my hands, staring into my eyes, and I can just hear very clearly every word she's saying.
And I should start with these like generic, you know, you're a good doctor, you've been kind, you're smart.
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Chapters
8 chapters
1
What is the main topic discussed in this episode?
0:00–8:36
2
What is the premise of Nikki Mittal’s ICU story and why did she share it?
8:36–12:34
3
How did Nikki’s personal life challenges intersect with the critical‑care case?
12:34–17:23
4
What happened during the family’s prayer session and how did it affect the doctor?
17:23–22:11
5
How did the prayer experience shift Nikki’s sense of failure and validation?
22:11–27:19
6
What does Nikki say about the day‑to‑day reality of working in a medical ICU?
27:19–32:55
7
How does she balance technical ICU skills with emotional family dynamics?
32:55–37:53
8
What spiritual or existential insights did Nikki gain from this encounter?
37:53–46:42