Nov 4, 2010
Intensive care units are devised by hospitals to make you believe that your loved one is being cared for intensively. You don’t have to be a rocket scientist to know that the Intensive care units are the breeding grounds for bloodstream, respiratory tract and urinary tract infections (BSI, RTI, and UTIs). Twenty four hour stay in an ICU is enough to give you four different strands of killer bugs! How do I know all this? It is because I’ve been in one and so, I have renamed them ‘Insensitive cash units.’ Let me tell you why.
Families of patients are kept out of these units because they supposedly bring aliens (pollutants, viruses, bacteria and the like) from the outside world and cause infections but the administrators forget the fact that they breed a variety of strands of bacteria right inside the ICU. The sub-zero temperatures in the ICU that are supposedly meant for keeping the germs out make an ideal breeding ground for infections. The so called life support systems in the ICU- the ventilators, suction machines, pacemakers and monitors that take care of all the vital functions for you also help in the growth of fungi, viruses and bacteria and the transmission of the same from one patient to another. Family members and loved ones believe that the infections are part of the disease process. You run like a fool making several trips to the hospital pharmacy and lug bags and bags of supplies. Just because you are spending a minimum of Rs. 5,000/- on meds, you assume (falsely) that your loved-one is going to exit the ICU alive. At first they try the traditional antibiotics and when the infection does not yield, they switch to patented/branded ones which means a bigger hole in your pocket.
Prior to my brief stay I had always wondered why the staff- the nurses, the paramedics and the docs in the ICU were outright cold. Now I know the answer. They stay in the ICU with the A.C. cranked up for 8-12 hours at a stretch and how warm can you expect them to be? Oh, let me tell you a thing of two about medical hygiene. I have seen it all. Gosh, they don’t wash their hands, they don’t wear gloves; they leave the used needles right on the bed of the patient. You see them run around the ICU looking busy with their hands in their pockets. I once saw the staff nurse pick her nose from under the mask with gloved hand and then handle the patient. Yikes!
I truly pity Dr. Grumpy’s patients (thank God he was not my doc.). Every day he comes by the unit two hours later than the scheduled time and eager family members flock around him as he is untying his shoelaces outside the unit. Yes, medical consultation is limited to the brief encounter you have with the treating physician when he is either tying or untying his shoelaces (on his way in or way out of the ICU). He does not even look up to see who he’s talking to and assures the family “He is doing better.” There is a lot of improvement.” I often wondered if he remembers his Hippocratic Oath. Now, don’t get me wrong. Not all docs are curt and cold. You see, my doctor is a great guy. I heard him tell my mom once: “Mrs. Noronha, please don’t stay here outside the ICU. Go and rest in the room. We are doing everything we can. I’ll come up to the room on my rounds and let you know how she’s doing.” I thought to myself: ‘Good for you Doc, may there be more like you!’
Dozens of families of patients wait outside the door with their eyes fixated on the clock.
The hour-long visiting time does not seem to do justice to their relentless agony. They just take a peak through the glass partitions during the brief visiting time and wave to the patient if he/she is awake or conscious and say “I see you.” By the time they catch the attention of the loved one and their eyes connect, the security guard comes barging in and declares, all visitors please go out, we are getting a new patient.” They don’t want you to see when they wheel the gurney in and transfer the patient to the bed and all masked faces gather around ready for some action. Some senior most mouth gives commands:“bag him, intubate, shock him” Believe me, the first time I heard these words I had thought that the police department has been instructed by the minister to kill someone and they were just staging a fake encounter! Having heard these slogans at least four times a day, I now suspect that these are the code words for life-saving medical interventions!
One morning as I was lost in thought I heard half a dozen voices sing “Happy birthday to you”. I tried very hard to open my eyes and see in the direction of the noise (yes, noise! you don’t expect a choir in an ICU, do you?) but my eyelids were not cooperating. They had sedated me to keep me from pulling out the Naso-gastric tube (the contraption they had inserted through my nose that reached the bottom of my stomach in simple words). Another name for this contraption is Ryle’s tube, although at the time of insertion it felt as if a garden hose was being shoved down my throat. This contraption is used to pour a glass of concoction (sweet lime extract, painkillers, antibiotics, antacids and at times just plain H2O) every two to three hours.
The singing just made my heart beat faster and the monitor I was hooked up to began making all sorts of beeping sounds. For a second there I thought I was dead and was having a re-birth. A few minutes later the anesthesiologist came rushing in wiping the cake crumbs off his mouth. Phew! I guess someone’s birthday is being celebrated; it’s not my rebirth. I realized life doesn’t come to a standstill just because you are struggling between life and death. The show goes on! The scrubs he was wearing badly needed a visit to the laundry and the stench that emanated from the green scrubs was enough to make one’s belly churn. I gagged as he approached my bed and he announced: “someone get me an anti-emetic, she’s nauseous.” “I am not nauseous you fool, it’s your scrubs.” I tried to tell him but no word came out of my mouth.
As the vial was being emptied into my vein, I tried to resist and push the stubby nurse away. Alas! They had tied my hands and feet to keep me from disconnecting the dozen hoses and cables (i.e., catheters). Right then, the anesthesiologist declared: “Oh no, she’s getting agitated, get a Diazepam shot ready. It seemed as though he had a prescription for every move I made so I decided to call it quits and pretended to fall asleep. I was not relishing the diazepam shots anyway.
I think keeping every patient sedated is not a bad thing after all. At least you don’t get to see all the disturbing things around you. Every time I opened my eyes my heart would miss a beat or two- the ICU staff walking around in gowns, masks and hands in gloves like aliens from an UFO was a scary sight. Now, I have learned not to be afraid when I hear a senior voice announce: “Time of death-3:35PM” though I still pinch myself to make sure it was not mine.
Two days went by and I heard the team declare: “It’s not working. Let’s not keep her hanging. Dr. M, you prepare the family. Let the family decide when they want her off life support.” I was glad they were giving up on me. I did not want to be on life support. Doctors prepared my family for my departure. Dr. M and the asst. anesthesiologist jointly decided to break all rules and to let the family come in and say good bye one by one.
I was grateful for this chance to see my family one last time and hold everyone’s hands thanks to this humane gesture of the docs (you see, not all docs are like Dr. Grumpy). After the goodbyes, the sighs and the tears, they turned off all the monitors and lo and behold, I began breathing on my own- my heart was beating, my so called failed kidneys started working again. The docs just gaped at each other and Dr. M said pointing to the ceiling: “We treat he cures. Divine intervention is mightier than all medical interventions put together” and I said: “Amen!” “Madam, looks like you have a new lease on life what do you want to do now?” asked the anesthesiologist. ‘Wow! from bed number 6 I had become a human being! what a difference life makes when you are no longer hooked to a bunch of machines.’ “Well doc, first thing I wanna to do is to go home and take a good shower. The punji baths (sponge baths) I had for the last six days have turned me into a real swine you see.” I was quick to respond.
Ever since this brief encounter with an ICU, my prayer has been please God, if your will is same as mine, deliver me from the snares of an ICU. If you have been unfortunate enough to spend a few days in an ICU but fortunate enough to come out alive you will know what I am talking about.
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