An intensivist is a doctor in a hospital intensive care unit (ICU). He or she tends to extremely sick patients, many at death’s doorstep, hooked to life-support equipment. Working among disconcerting alarms and bleeps from the machines is an emotional rollercoaster ride. Two patients in the ICU I work in were a handful in emotional terms recently, so much so I dreaded taking the rounds.
The first was a 22-year-old engineering student who had widely disseminated colon cancer and renal failure. He was operated for intestinal obstruction from advanced cancer. A surgical attempt to enable him to eat something before death snatched him, proved futile.
He pleaded to be sent to his room to be with his dear and near, which was a reasonable request, considering his condition and prognosis. But he was ‘clinically unstable’, and I attempted to reason with him on the need for staying in the ICU.
Looking me in the eye, hopelessness writ on his face, he told me: ‘Doctor, you know I’m not going to live. Let me at least be with my parents before I die.’ I stood there torn between a man yearning to spend his numbered days with his parents. Somehow managing to convince him, I discharged him to his room. After a few days, he died.
The second was a woman in her 20s, who met with a road accident. She had pelvic fracture and liver injury. She lost her sister, whose death she witnessed in the car that had somersaulted, due to a burst tyre. She also lost her tiny daughter, who she remembers sleeping on her lap at the time of the accident, but succumbed to injury. The ICU drowned in her wailing as the bodies were brought in, on her request, ‘for a last look’. There wasn’t a staff member without teary eyes. It was hard to work in the ICU that day. Having recovered, she was sent from the ICU to a room.
In a profession that runs on well-laid out ethics to work toward ‘clinical stability’ of patients and situations where circumspection may have to be sidestepped in the interest of humanity, an intensivist’s job is tough.
earaly@hotmail.com
