I thought I was tough. I thought I could hack anything medicine could throw at me. I thought ITU would be fun. Thats 3/3 wrong.
Surreal was translating clinic letters from a language I don't speak to get a PMH on a guy who's about to go for his third orthopaedic procedure in a week. Every limb you can break was broken when his vehicle hit another. His wife is in the hospital too, with C-spine fractures. Watching two teenage girls see their dad for the first time and not crying is the hardest thing I've done this week, including exams.
Surreal is watching a man, handcuffed to a policewoman, cry over his unconscious alcoholic mother.
Meningitis in lectures is fine. Meningitis in a lad my age, on every organ support machine possible, is not.
I've learnt that there's a special type of COPD you can get from smoking heroin. That a litre of vodka a day will make you fall out of your wheelchair and give you a massive subdural haematoma, and surgery to fix that involves more scalp staples than I ever thought possible. That whilst ITU is not the worst place to die, it is the worst place to be a conscious patient. That no one leaves ITU without after effects - dead, disabled, or PTSD & hallucinations. That the healthiest looking patient on the unit is the one with terminal cancer, conscious and talking, with less than days to live. And the logistics of taking an intubated patient home to die are nigh on impossible.
Yesterday I held the hands of someone who was getting his central line changed, whilst heavily sedated. I had to prise his fingers off mine at the end. Today he is dead.
It is a vegetable patch. Row upon row of slanted mounds of patient. I have heard medicine reduced to such a molecular level over the past two days, it was hard to relate it to the slab of flesh in front of me. Patients talked of in terms of biochemical figures. Of vessels of infection.
A consultant admitted that most of what they do would be considered torture in any other context. Yet the nurses reassure relatives with the "No pain" line. I stuck six cannulas into two patients. Both squirmed and withdrew, despite being "comatose". Four failed cannulae, just from me. I saw 3 attempts at an NG tube, which ended when they suctioned 200ml of blood out of his throat. Blood that wasnt there when they started. Hands bandaged like mittens to prevent tubes and lines being yanked out. Consent and Gillick competency don't exist.
I can't write any more. I could, but I think 6hrs sleep over 2 days is adversely affecting me. I DONT CRY. Except after ITU.
