starting ICU

On the day before starting my ICU rotation, which inspires a unique kind of fear, we received information about the current patients in the ICU. It's pretty amazing how sick these patients are. Even though I have no interest in doing critical care in the future, it's definitely a good experience to see how much people can go through and survive. Reading about one person with a urine that contained heroin, cocaine, benzos, and opiates, I think about all the toxins we accumulate in our lives, concrete and otherwise. It's both our absorption of these, and our resilience against them, that gives so much value in caring for critical illness.

Now on day three, I think back on what's happened:

Day one: Death A patient who collapsed in the morning was brought to the emergency room. She had one event after another in rapid succession throughout the day. In one day, her years of functioning came to an end. Piecing together what happened to her medically, imagining how she existed before this, communicating with her family--being in the ICU where things can evolve quickly means having entire narratives ravel and unravel over one day.

Day two: Achievement I don't have much experience with ICU-related procedures, in part because I haven't had much ICU experience and also because I'm known as what they call a white cloud, where I find myself just not having as many patients and many emergency situations as a lot of other residents, which can be a good thing but also means that I'm less prepared coming into this than everyone else. So our ICU fellow was very nice and approached me to do a procedure to get practice. Which I promptly failed twice. But when later that night I was by myself and had to do it again, I was able to do it on my own. I was proud of myself for braving it alone instead of immediately accepting that I wouldn't be able to.

Day three: Failure I made some poor decisions about a sick patient overnight that became much more evident in the morning to everyone else. There were several points where I could have done things differently, and I know that other people in my position would have done things differently. But I'm trying hard not to compare myself to others, and to remember that there are different strengths with different visibilities.