2 posts from my MySpace page

Below are 2 post that appear on my MySpace page. One from Monday night and the other from a few minutes ago.

Post #1

Monday, October 16, 2006

PICU
Current Mood: Exhausted

So I am in the Pediatric Intensive Care Unit this month. Sick kids...really, really sick kids. Their sickness doesn't bother me. I'm not even that emotional when things don't go good. I've actually been surprised by this. I'm the kind of guys who's secure enough in his manhood to not feel bad about crying at the movies. Hell, I even cry when watching ABC's Extreme Home Makeover (and I believe you're not human if you don't). But the last few weeks in the PICU have been tough. We've had a few kids die and there are a few more that will likely die in the next few days/weeks.

My reason for this post is this. HEAR ME!!! We, the medical community (nurses, doctors, med students, lab tech, unit clerks, respiratory therapist, nutritionists, pharmacists, and anyone else that I've failed to mention) are here because WE WANT TO HELP PEOPLE!!! We WANT people to get well. Especially kids.

When you read in the newspaper about a hospital moving to withdraw support on one of their patients...it's not because of money. It's not because we need the bed. It's not because we don't like the family. It's because with all the medical knowledge and in review of the patient's case in its entirety...there is NO HOPE that the patient will recover.

Our hospital has an ethics committee. When a case goes before futility, that means that the hospital is requesting that life support be withdrawn against the family's wishes. That committee is made up of 10 people. 7 physicians (not directly involved in the patient's care) and 3 nurses, also not involved in the patient's care. After review of the facts, the committee MUST be in COMPLETE 100% agreement. The decision MUST be UNANIMOUS!!!! The family is then notified of the decision and has 10 days to find an institution willing to accept care. The hospital will even help facilitate that in some cases. If no facility can be found, support is withdrawn after the 10 days.

No one wants it to come to this, and we're not hoping for anyone to die. But that's not the world that we live in and unfortunately people do die. I can also tell you in most of these cases, that 50 yrs ago, this conversation would never have happened because we didn't have the medicines or the understanding of the physiology or the ventilators sophisticated enough to get to this point.

When I became a doctor, I swore an oath. That oath says to do no harm. I believe that using medicines and machines to keep a person alive who has no chance of recovery...is doing them harm. To watch as they slowly lose fingers and toes because their body can't maintain the blood pressure necessary to supply their organs and extremities is doing harm. In fact, it's cruel.

I pray everyday that God will give me the strength to get through another day of work...especially in an ICU. I pray for the wisdom needed to provide the very best care for my patients.

I'm not asking for you to agree with me. I only want you to know my opinion. I welcome the chance to know yours.


Post #2

Prophetic, but not in a good way
Current mood: determined


If had known how the next 42 hours would go when I posted my last blog...I wouldn't have.

Yesterday/Last night's call was the worst night of call that I've had since entering the medical profession.

The day started with a patient dying. While not unexpected, a child died, and that's never easy.

I then proceded to admit 7 patients. 7 ICU level patients. Granted a few of them were post-op still intubated observation patients...but there's still a lot of work that goes into getting them admitted.

Once evening arrived, all hell broke loose.

My fellow and I spent the next 12 hours taking care of 3 very sick children. It was so bad that our attending came in from home. Not because we're not competent, but because the kids were that sick.

On more than one occaision last night, I had to go look 2 parents in the eye and tell them that their child was so critically ill that I didn't know if he/she was going to make it through the night.

At 6 a.m. we turned the ventilator off with the child's parents at the bedside. It was the saddest thing I've ever seen.

But I survived. I'm still standing.

If we are never stretched, we never grow. No one ever said this would be easy. I never expected it to be.

Today marks a new day for me. It's a day I will never forget. I have much to learn. There is much to read and much to do.

Right now, though. I need some sleep.