Death’s Diving Board (oh, and figure skating…)

Today is going to be a short and sweet entry as, well, I’m pretty exhausted.

This week I have seen two patients leave the Intensive Care Unit that I thought perhaps never would. Both were our resident guests for 41 days and 39 days respectively. Both had multiple organ issues – and indeed failures – that stacked the odds very much against them ever leaving the unit alive. Both suffered cardiac events (heart attacks, basically) and one was intubated and ventilated for well over 35 days. In fact it was only day 40 that this patient even had the ability to speak (tubes down your throat do tend to hinder this capacity of course….). It is a true testament to themselves, the ability of the human body and all of its marvelled physiology and biochemistry to work to maintain an internal environment compatible with survival…to fight for that homeostasis. It is also testament to the teams of nurses, health care assistants, chest physiotherapists, dieticians, imaging specialists like the echo-cardiographer technicians and radiologists and finally the doctors (I am sure there are many others too) that work to keep these patients alive in the first place and secondly try and get them to some pre-morbid function that will allow them to continue on with their lives with some degree of independence. I count myself as the very bottom of this list (after-all a few cannulas and chasing of scan results hardly impacted that much) – but all the same, I am proud to be at least a very small part of a very big and experienced multi-disciplinary team!

This is amazing because these patients, and many, I am sure before them, before my life as a doctor began, have stood on what I have decided to call “death’s diving board”. These patients have stood on the end Death’s diving board, toes curled around the edge, head pointed down and hands outstretched, ready to stop living. The decisions, interventions, desire, physiology and timing will decide whether they make the leap and don’t come back…or step away from the edge and head back down the ladder to terra firma. So this week I got to see two patients come down that ladder and go from being intubated and ventilated, lifeless bodies with machines surrounding them acting as their organ support – to patients who are eating and drinking, joking with me and telling me about their lives and what they still want to do with them. Sadly for every one that steps away from the end of the board, and new one is already climbing up the ladder to take their turn at peering over.

And you know, amongst all the tiredness, long days, and self-doubt about whether you (I mean me, obviously) should even be in hospital with the title of doctor, it is the week’s like last week and results like that which make me think maybe, just maybe, it is worth it.

Have a great week everyone and hope the Sochi Winter Olympics have inspired you! What people do with their bodies is truly amazing – and no truer display that than over the last 18 days! My personal favourite which came much as a surprise to me as to anyone was the figure skating….how just how they manage to effortlessly float across the ice, jumping and spinning is just, well, you cannot do anything but just marvel at it. I know I did. Ok, and yes, they were very attractive too…

See you next week!

Dr Nick

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