I remember a time when I “owned” the ICU. I had eight patients – eight – who were severely brain damaged, irreversibly brain damaged, or brain dead. I don’t remember all the diagnoses, but they included aneurysms, intracerebral hemorrhages, ischemic strokes, hypoxic encephalopathies and a bad surgical outcome.
During my ownership stage, the MICU staff were absolutely great in using my time, as they shepherded me from one family group to another. It is easy to get jaded when one faces bad, irreversible or total brain damage in eight patients that one needs to see a few times a day. I tried not to be, but I don’t know how successful I was. Taking time to talk to families is often a real pain, but it is necessary, deeply appreciated and what physicians get paid for. Do it.
If I returned to medical practice, which I won’t, I would be a far more compassionate physician than I was during the twenty years I did practice. Mind you, I think I did a good job. I allowed patients to die at the right time with dignity and less stress on the families. When it came time for my parents to die, I did everything I promised them, and neither lived more than eight weeks from the time they started to die. Ensuring the quiet, painless dignified deaths of my parents was one of the best things I’ve ever done in my life.
If you want to read about how I dealt with the change in my relationship with my father, after he was widowed, read A Wise Owl. That is probably the best thing I will ever write.
But having lived through their deaths and several personal infirmities, I look at life a good deal differently. I could now tell families how it is normal to feel guilty when it is time to stop life support. I could tell them how one will miss having that loved one to talk to, all the conversations that one would want to have in the coming years. I could tell them how the relationship between children and surviving parent would change. I would really be compassionate, because I have been there.
I’ve had two major infirmities of my own in the past decade. The first was getting buggered when a Buick turned in front of my bicycle up in Durango. I went down and hit my fortunately helmeted head on the bumper. Remarkably optimistic (some would say stupid), I got back on the bike, not realizing I had broken my right femoral head, the coronoid process of my left elbow, my fifth right metacarpal, and had a comminuted fracture of my right index finger. I actually rode the bike six miles with these injuries, hobbling 100 yards into the school where the group was staying to take a shower. While I was drying myself, the bench on which I was sitting collapsed. It was a totally crappy day.
Denial wore off when the adrenaline did, and I was operated on that night. I had one functioning limb for about three weeks, and I was pretty damn miserable. But I healed. Still, I know what it is like to need a handicapped parking spot, have kids say “Mommy, what’s wrong with him?” have people hold doors and yet not wanting to be treated like a invalid. I was a full-time graduate student then and teaching basic stats to college students.
More recently, I had a nasty non-life threatening miserable infection for several months. Without getting into details, I really didn’t want to live with it, which put me into counseling and from there into self-hypnosis. Once, I might have been skeptical of self-hypnosis, but desperation changes one’s mind set, and it is amazing what hope and practice can do. I can now get myself into a deep altered state and become pretty comfortable.
During this infirmity, I went on the Internet and learned a good deal about the condition. As much of a scientist as I want to be, there was simply no way I was going to try one thing at a time for a few weeks and see what happened. I was too uncomfortable. Rather, I tried a few things, had hope, lost hope, wondered what else I could do, figured out something new and kept going.
My advice? Do your research. Hope your doctor is willing to work with you. Write down questions, which is something I always hated patients doing. Hope your doctor calls you back when you have an occasional question. Try things. Try other things.
I took sleeping pills every night for a month, because getting sleep was one thing that really helped. My condition didn’t affect my ability to exercise; indeed, exercise seemed to alleviate it. So I tried to stay in shape. I canceled a volunteer trip to Nebraska to help out with the Cranes. It broke my heart, but it was the right decision. Two other trips on the chopping block were at the moment salvaged by great people who knew me and gave me a bit more time on paying the final deposit.
I’d be so much more understanding of patients with chronic conditions today. I’d be a wonderful doctor. Too bad it took me so long to figure it out. Don’t you make the same mistake.
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