Sunday, August 18, 2013

a mother

So you don't want to let him go. "Brain dead." They all file in, in groups of two or three, somber faced, long white coats. Nurses touch your shoulders in the hallway, they speak to you in low tones. Slow, measured words. Your child, your child, he is gone. In every meaningful way, gone. But his heart is still beating. Yes, mechanically pumping away, refusing to stop. A machine with no more soul.
You don't want to let go. You've held him all of his 23 years. You've bathed him, wiped his forehead, learned to decipher his mouthed words. It was your genes, wasn't it, that did this to him? You have lived your whole life in penance, your devotion to him is your self-flagellation, it is your salvation. Don't take it away, you think, because then what?
I'll tell you "then what". Then you cry, you cry for weeks, months even. You save things that were his, touch them, sleep with them, smell them. You throw yourself into his remembrance. You shop for grave stones. You spend hours at a cemetery, staring at his name on the stone, not sure how you got here, who you are, why the name is there, and not on report cards, or drivers licenses, or passports instead. You will beg, each night before sleep, beg and plead for the universe to undo it. Make it go away. You will count each minute, each hour, each day since you last touched him. You will live on, showering, dressing, wiping the kitchen table, spooning food into your own mouth. You will just keep going even when he has not, and that is terrible. Truly terrible.
Herniated. We say the words. Herniated. We equate it with death. We have already decided. But you hear a heartbeat, you want to keep listening, you want to be able to reach out and touch his warm skin. They pronounce him "brain dead". After much delicate handling, they finally tell you that they will not prolong him in this state. They will not. They bring the imam. They bring the ethics committee. They bring the patient relations representative. You call every hospital in the area. Keep my child alive, even if he's not really living, you beg.
We shake our heads, we mutter "crazy" under our breaths. Everyone is fed up, absolutely fed up, of this carrying on, this refusal to face reality.
How glad I am that I did not have to say, "yes, go ahead, withdraw". The choice was taken from me, and I'm grateful. I understand you. I want you to change your mind, but I understand you.
Peace of the universe to you, mother.

Monday, August 12, 2013

highlights of my day(s)

1) The other day one of our patient's needed an emergent ex-lap (exploratory laparotomy) for abdominal compartment syndrome, so the ICU room was turned into a temporary OR. And we all wanted to watch.
2) The GI and Surgery consulting teams spent a whole day contradicting each other and sabatoging each other's plans. The ICU team got her extubated and off pressors. Consulting teams: get along or get out!

3) The patient in the above scenario spoke Chaldean, which is a dialect of Arameic, which as you can imagine, is not a widely spoken language in these parts. In fact, it is spoken only by certain natives of Kurdistan and its diaspora. My other patient spoke Spanish. I speak neither.
4) I'm excited because my hero, friend, and favorite doctor of all-time is on the Palliative Care team, and my patient needs a palliative care consult. I know, I know, it's all about me.
5) Is anything better than a physician's permission to NOT do a sedation holiday? It's like a get-out-of-jail-free card! (Once again- all about me.)

Saturday, August 10, 2013

fellow ICU blogger

Does everyone reading this follow Perspective is a Lovely Hand to Hold?c

This blogger is an ICU nurse who can really articulate the gravity of what we face in the life and death situations that make up our "mundane" work day.

This is not only my favorite nursing blog, but one of my favorite blogs period.