The Star Wars of Medicine: Intensive Care Unit

So last week I finished up surgery. Walking away from the battle-ground of surgical wards and operating theatres was a fairly liberating experience. Bloodied and bruised from my 4 month encounter with perforated appendices, angry surgeons and post-operative infections and sepsis, I was relieved and exhilarated all at once. I had, after all, folks, just survived what was my most dreaded junior doctor rotation. With that box ticked, I look to the future. What next?

Intensive Care.

What a contrast. Walking onto the intensive care unit transported me into the future of medicine. Each patient was neatly packaged into one of the 8 bed intensive care unit’s bays, with several large machines all connected to them and an authoritative nurse sitting at the end of each bed marking down the numbers on an over-whelming large piece of recording paper – heart rate, blood pressure, urine output and so on. This really was meticulous medicine.

It’s a good time to say, that a bit like Ronsil “does exactly what it says on the time”, these patients are also all very very sick – and hence requiring Intensive Care. Here, The majority heavy sedated, intubated (i.e. a tube is put down their throat to pass oxygen rich air in) and ventilated (i.e. mechanical breathing done for them, rather than you or I’s automatic breathing we do without thinking). They all without fail have tubes going into veins and arteries in their necks, forearms and groins with baffling names like “central line”, “art line” and “vascath”.

The Unit too is constantly met with the chorus of machines…..“bleep…bleep….bleep”. And of course the all too often cardiac arrest buzzer. They after all, very sick here.

And you know what it all looks terrifying to the untrained eye. I consider myself, by the way, currently in that category – untrained. The only positive I can see at the moment is that I know what all these lines, tubes and machines are for (although have no much idea at the moment of how they quiet work or how to put them in – though that will come with time) and that everything that is said and done is for the patient.

I am only a week in but already I understand that medicine on intensive care is about optimising the human physiology to the nth degree. It is fine-tuning for survival – life and death. I find this fascinating and am sure that the next 4 months will be eye-opening, technically demanding, dramatic and emotionally draining. What an experience I am in for….

Speak to you next week.

Dr Nick



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