Plot Twist, Part II

A continuation of my series on my recent health scare. You can read Part I here

There is no night in the ICU. They dim some of the lights, but not enough for a light sleeper like me. There is always noise. Those of us lucky to be guests in this unit are under constant supervision – so unless you’re in a coma, there’s not a lot of rest. Visiting hours are also 24/7, which is completely understandable. If something goes wrong in the middle of the night, you don’t want to wait until 8am to see your loved ones. 

There is also very little privacy in the ICU. No one has their own room, despite what they show you on TV. Each bed is separated by a curtain, and most of the time, mine was wide open so they could keep an eye on me. (It was also slightly less claustrophobic that way.) Ergo, I could see and hear everything that was going on around me. For instance, I witnessed the immediate aftermath of one death. The patient was surrounded by several family members who formed a slow procession behind the gurney as they wheeled their loved one out for the last time. A few of them tried to smile at me as they walked by, but most of them were lost in shock and grief. It was a difficult and beautiful thing to watch at the same time. Whoever passed, they passed with the love and support of their family.

The realization that I was in the same unit as the person who just passed didn’t come right away… but when I was lying awake at 2 in the morning as the automatic blood pressure cuff started inflating as it did every hour, and the monitors I was hooked up to chirped a little at my high pulse rate — it hit me, and hit me hard.

Shit. I could have died. I still could.

I don’t think I have ever felt more scared and alone as I did at that moment. It was incredibly humbling. I am in my late 30s. Mortality has always been sort of an abstract concept rather than an integrated reality. And the truth is, I still could die from this. Even right now as I am writing about it. But the fact that I haven’t had any symptoms remotely like what happened during “The Event,” my vitals are normal, and my energy is returning … chances are pretty darn good that I am going to be just fine. I just need to let the blood thinners do their work, and be very regimented about my recovery. (And you better believe that I am following the doctors’ orders to the letter. I am NOT going through this again.)

One thing I have to say about the ICU is how incredible the nursing staff was there. They should all be sainted. I didn’t see any one of them lose their professionalism, even when they were joking around. They knew how hard it was to be there, and they did their abject best to see to my needs and my comfort, despite the fact they were dealing with some challenging patients – such as the Polish guy whose lucid moments were in English and his delusional moments were in Polish. Loud, screaming Polish. And sadly, his delusional moments were more common. Then there were the brother and sister sitting vigil with their mother. I will not deny anyone the opportunity to do just that – but please keep it down for the rest of us. They were loud talkers… all night long, and quite demanding of the nursing staff.

My only complaint about the medical staff was during morning rounds with the attending physician. I mentioned that each bed is cordoned off by curtains. You can hear everything. Therefore, if you’re discussing a patient with a serious medical condition, it might be best to either a) open the curtains and acknowledge that she is there or b) go outside where she can’t hear you. The attending stood outside my closed curtains and said something to the effect of, “If she throws another clot, she’s gone. She can’t take another one,” along with a bunch of other equally scary statements. I was literally 3 feet from her. No one was with me. And I was terrified. 

Then the parade of doctors came through – pulmonologists, cardiologists – each with their own idea about how best to treat me. I had an echocardiogram of my heart and ultrasound on my legs. Everyone then started offering me increasingly scary options that included everything from giving me a blood thinner regimen that could cause me to bleed in my brain or stomach to two different kinds of surgery. The aggressive blood thinner approach scared me because if I have learned anything from this (and past experiences with medication) – if there is a side effect, I am going to get it. It’s what makes me special. And surgery… gods. I didn’t want to contemplate it.

I apparently fall in a very gray area when it comes to these aggressive treatments. For some people it is very clear that they absolutely need it, others absolutely not … but I was a risk that could go either way. So the pulmonologists eventually won out and we went with the more conservative approach – which is a blend of less-aggressive blood thinners that would get me to a therapeutic level that will ideally dissolve the clots. 

The conservative approach appeared (and still appears) to be the right decision. When it looked like I was stabilizing and my vitals remained normal for 24 hours – I got moved to a private room in the Telemetry unit. Still under constant supervision, but my monitors were wireless. I could do things I take for granted like go to the bathroom by myself. I had a door I could shut and lights I could turn out. But most of all… I had the doctors’ increasing confidence that I would pull through. And that was what I chose to focus on at that moment.

Next up… adventures in the land of HMOs.

 

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6 thoughts on “Plot Twist, Part II

  1. Yikes about the attending making scary comments where you can hear but not reply.

    Speaking from the perspective of a chaplain working in a hospital, I hope you’ll give the hospital some feedback about that. A resident making that kind of comment ought to hear about it, and probably will. But attendings in many hospitals might not. And no patient deserves to have that kind of crass treatment.

    Delighted to hear that you’re planning to survive this first intimation of mortality!

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  2. I think I will pass that feedback along. The attending redeemed herself later when she came to talk to me directly, but yeah… that blatant disregard for the fact that I was *right there* even if I was behind the curtain was really awful. The ICU is not a great place to be at the best of times, and that just made things worse. Thanks for the perspective.

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    • I wanted to echo the comment by maggiebea… that was incredibly unprofessional of the doctor, and the only way it will change is by complaints from consumers. That hospital seemed VERY concerned with patient perceptions; I think your comments will carry a lot of weight.

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      • Oh, and please send a note or chocolates or cookies or something to your nurses, if you liked them! They get treated like SHIT by the docs, and also by a lot of patients (as you noticed). They will be flabbergasted and extremely appreciative of any gesture you make, I guarantee it (I say this as the daughter of a career nurse!).

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      • It’s on the list. 🙂 I need to wait until my budget and bills get settled over the next week, but both the ICU and Telemetry are getting something sweet as soon as I can send it.

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  3. Oh, thank you for sharing this. I can relate all too well to the fear of being an ICU patient and the lack of bedside manner (putting it nicely) of some physicians. Negative energy like that just disrupts healing, in my perspective. And I agree a million percent about the nurses. They are the true caregivers. Your blog makes me think of some of the tweets from Scott Simon over the past couple weeks in regard to the ICU nurses caring for his mom (https://twitter.com/nprscottsimon)
    Here are two of my favorites:
    “Journos [journalists] who say they’re hard-boiled cause they see so much should know ICU nurses see more in a week. And come out kind.”
    and
    “ICU seems to be staffed by good, smart young docs who think they know everything, and wise RN’s who really do.”

    big hug to you….

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