Retrospect

It was my medicine posting during internship, I was posted to the ICU, we had ten patients. In ICU, I guess you have to stay with cross fingers, because most of the patients show a gradual prognosis, good or bad. There was this young girl who had attempted suicide by hanging, had a tracheostomy and was on ventilator, she had been in ICU for almost 25days, her muscles were atrophying and there were contractures, she was a vegetable, it broke our hearts to see her dad sit and keep talking to her. There was this young guy with Guillian-Barre syndrome, who had a bunch of friends as his attenders, they wouldn’t let his mom run around for anything and they joked around the nurses, the boy recovered and it was a happy farewell from the ICU. The story I want to share is another one though.

For an ICU, to be efficient, the most important is the nursing staff, and we had an amazing team. There was this senior sister who had set her heart upon a 17 year old girl on bed no.10, we were still working up on her case. She was on BIPAP, she used to keep taking off the mask because of the discomfort and this sister would promptly keep putting it back on and warning her. Her x-ray images showed worsening, and she was going into ARDS. We were still oscillating over her the primary diagnosis, while putting her on muscle relaxants and sedatives and ventilator. Her parents were so scared, and we were monitoring her by the hour, day and night.While talking to the girl’s mom, the sister elicited history of the girl having attempted suicide along with her friend a couple of weeks back, for which she had been taken to some local clinic from where she had been discharged once she was doing fine. They didn’t know the compound she had consumed, so we dug deeper and told them to get the information on it. In a few hours, they got a picture of the container, and Lo! It was paraquet, one of the dreaded poisons cause the fatality is almost 100%, sooner than later. They hadn’t given the entire history during admission. My senior counselled the attenders about it, she was deteriorating fast, it was just matter of few hours. The parents were blaming themselves, the friend and fate. They thanked us for trying our best. I wonder what thoughts will run in their minds for the rest of their lives, they didn’t even know it was the poison that was working its way for so long, it took so long is a wonder in itself for us.

ICU duties are overwhelming, we will get invested in our patients, in their attenders, a bond is formed. Death feels palpable sometimes and beeping machines make it’s approach audible. It’s an amazing place to observe a disease progression, follow up investigations and good seniors can teach the tech side of medicine.