16. TALE OF ICU

With all the anarchy around, I slept off in the ICU once after a continuous 36-hour shift along with taking care of Pihu-Ruhi combination.
As I dozed off, I dreamt of a weird white coat guy standing in front of me.
With all excitement and nervousness at the same time, I asked, -
“Who are you?”
The mysterious person replied, -
“Me… I shall tell that later, fist let me talk about the biggest irony of life –
Airports have seen more affectionate kisses than wedding halls.
Walls of hospitals have heard more sincere than the walls of Temples, Masjid and Churches.
Tick! Tick! The clock is the most scared thing in a hospital.
When you are fighting for life, you need more than just medicine.
Pain. Prayers. Positivity. Multiple traumas, a room full of ventilators, ECGs, defibrilators. Patients have been trying to face death around my walls,
Did you not get who I am?
I am ICU!
Intensive Care Unit!
I was born about 70 years ago, in 1952 in Copenhagen because of polio epidemic back then.
This is the result of many numbers of patients experiencing respiratory failures.
Or the critical conditions of them otherwise.
Many students across medical and dental fraternity to hand ventilate via a tracheostomy.
Bjorn Ibsen, the anaesthetist came up with a concept of me where positive pressure ventilation as a treatment of choice in Europe.
He can be considered to be the Father of Intensive Care Unit, or rather me. Hahaaa….
Right form ventilators to endotracheal tubes to tracheostomies to nasogastric tubes to suction pumps to monitors to catheters.
Drugs for primary and secondary care are well organised and labelled. That’s how I have been functioning since inception!
The atmosphere might look all complex, but that has been the life support at time of distress.
Doctors, more so intensivists, anaesthetists, staff nurses, and other workers work round the clock.
The chaos!
The confusions!
The screams!
I have witnessed it all!
I feel happy and content if someone recovers. The happiness on attenders’ face is irreplaceable.
I wept along when there was a loss of near and dear ones, even as they were clueless and wary about it.
That has been my routine all these years. I have also beheld surgeons giving in their best shot with long working hours.
I have also seen them collapse down with stress. The situation was no different in case of COVID.
Beginning from early December 2019, the sudden outbreak of Corona virus pandemic requires a robust solid administration for management of critically ill patients.
The outbreak challenged my status quo at various levels. These include resource limitations.
Protection of healthcare workers, and more so to adapt to rapidly evolving situation.
This commences right away where engineers had to create a negative airflow isolation room in the hospital setup. More so in an ICU – within my walls.
A Covid ICU ward in a hospital is like a T-20 match in progress.
Much like in a game, as one's eyes are constantly transfixed on the ticking scoreboard, in a hospital, one is continuously scanning the electronic display board above beds, which displays pulse rate, oxygen level and blood pressure readings.
A patient's caregiver is busy monitoring that. If the oxygen level goes up by a point, the caregiver is upbeat and the patient too feels assured.
However, a drop worries both!
This match then goes on for days. Then one day either the patient wins the battle or the display board above goes quiet.
Life loses and the soul proceeds on its unending journey. A higher power, acting like an umpire, is making those decisions.
Precise, for the outer world, the isolation wards were divided into hot zone, warm zone and cold zone.
A hot zone would be fairly of an area contains highest risk of contamination where PPEs had to be worn in full clad that had to be removed on exit.
Warm zones constitute of moderate risk for contamination. This is like a bridging station between rooms of infected patients where clean N95 masks, new gowns are worn because of potential airborne pressure situated outside of patient rooms.
A cold zone has no risk of contamination. For example, Nurse stations, drug stations.
I have also witnessed anxiety, depression and burnout among these health care workers.
These mental health determinants rank from age to gender to region.
Occupational hazards proportionated with emotional quotient among physicians was the highlight of the pandemic and I have been witnessing it from time to time, not just Corona.
Number of patients who are managed vis-à-vis the number of shifts per month or rotation or calls the intensivists had to cater to.
For medical fraternity, a patient is a patient. But for the relative, that patient is the entire world…
Just like how a candle burns out giving light to others, it takes a toll on doctors and other associated people personally.
This is the prime reason for burnouts!
Now, you people have put me with more modern technology and trying your best to pull people towards more life than death.
Let’s get back to work, Doctor!”
That shook me up from a small nap I had and got back to attending patients. Alas! Majority of hours were spent at hospital than family…. Work-life balance?