So I started my ICU rotation this past Monday. This is a rotation I have been dreading all of intern year because I don’t really like caring for really sick people. I don’t mind taking care of some sick people but having 4 patients who all have one foot on a banana peel is a bit much for me. I tend to get personally invested in my patients and it’s really tough to watch people die.
The past few days have been especially challenging. I have a patient who is dying (very actively dying). The family isn’t sure whether or not they want to withdraw support. This is a guy who has been in a nursing home for months, not mobile, not speaking, nothing. That for me is just not living. Too many people keep their loved ones alive to assuage their own guilt. I have already told everyone I love and who loves me that if I am brain dead, not coming back… pull my plug! The poor wife, this is a horrible time for her. Her husband said he didn’t want to live on machines but she’s just not sure what that means. But seriously, the guy isn’t aware of his surroundings, his eyes are half open with no response. Let go. Every time she gets ready to withdraw care, the primary physician on the case manages to talk her out of it. For what? Do yourselves a favor, everyone (all 3 of you.. LOL)… have an advanced medical directive. Talk to your loved ones about your wishes and put them in writing!
The interesting thing is that I’m such a family doc. We were discussing the plan of care with my patient’s family and the wife started crying. I had several discussions with her prior to this and started to build a good rapport, so I put my hand on her shoulder and told her that I know it must be hard for her. The family started crying and my immediate response was to get tissue for everyone. Perhaps that stems from having been a family member with a dying loved one or just from a connection with human emotions. My senior resident was with me and even she was surprised that I got tissues. I didn’t have to say anything, sometimes just one small act of dignity helps a person feel better. It’s really hard to have a serious, focused discussion when you are trying to snort up the snot bubbles.
Thank goodness ICU is only one month out of the whole year. 7 months of intern year down, 5 more blocks to go. I still have 2 more months on our inpatient service, a month of OB-Gyn, ER and Ambulatory Pediatrics/Nursery left. Go me!!
