A day to breathe


During months that I man the ICU, I get 2 days off for sanity because the rest of the month its either I have my heart stunned or in hibernation. Either those or I’m in shock. Most of the time, I’m probably in shock from awe of how fast and dynamic things are in the ICU. Like this one patient I had: a 65 year old man, a runner/ race car driver who came in SP ELap because of psoas abscess from ruptured appendicitis. He had a chest xray that looked atelectatic (post op?) so we had him on CPAP day 1. The following day, his chest xray now looked like ARDS but clinically he looked fine. We had his ABG taken that read respiratory alkalosis / metabolic alkalosis, and oh, the PF ratio was 75. He was intubated but ABGs remained the same without improvement in oxygen – still 78. So he was proned. Just like that, someone who probably had more cardiac reserve than me was now paralyzed and sedated. That fast.  And while my consultant made all that happen, there I was soaking everything in. When his wife came in, I had trouble explaining what happened, although my head was full of these medical jargon she wasn’t probably ready to understand. But despite this, I like the rush I get when I’m in the ICU. Its addictive to some extent, likely enough to drive me crazy if I stay there straight. Hence, this quick out of the city get away.

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