Friday, October 26, 2007

Sad-Eyed Shroomy of the Lowlands

It seems most of what I write these days is apologies for not writing.

My mood has been lower than usual of late. Work, money, work, personal life... blahblahblah.
I'm still disappointed my life isn't quite ER. Ah, well...

This month has been PICU month. I'm due a 3 month Paeds secondment, but it hasn't been possible for me to do it all at once. So, I got a month. I haven't done any ITU for a while, least of all Paeds. So it's been a valuable experience, albeit perhaps not exactly what I thought.

Intensive care is an odd place; organised, controlled chaos, if you like. When I worked on adult ITU, I think it was then that the psychological trauma began to build up. Maybe. I found it very hard to see so many die. Especially the younger ones.

Now obviously in Paeds, they're all young. But it seems to me that few of them die. Which is nice.

Instead, what I have found challenging is watching the head injuries. The ones I've seen tend to be older - in their teens - and were usually on the wrong side of a moving car. They have non-operative CT scans - no large extra-dural haematomas to be hoiked out by my neurosurgical brethren. But their brains are tight.

Recovery is slow. Slower than I'll know, as I haven't seen the neuro-rehab ward. What I find frustrating is how non-specific we have to be to the parents. They'll probably survive, but we have no way of knowing how they'll survive.

It is the worst of things, and the best of things. I have never been more amazed by the strength of human spirit than I have watching the parents of these kids. I simply cannot imagine how it feels to have to come to hospital, day after day, and look at your son or daughter, previously so full of life, so vital, and look at them, pale and waxy, tiny in an adult's bed.
And keep smiling.

And once all the tubes are out - the ETT, the bolt, the EVD, the drips and all - they aren't better. They look around, blankly, their limbs flailing. Trapped in a body that won't obey them. And still mum and dad come in, holding the patient's hand, lying in bed with them, holding them tight. No parent banks on having to watch their adolescent be nursed in an adult nappy, on having to help bed-bath them. But they do it. I don't know where they find the strength.

And then... sometimes they just stop flailing, and start looking around. They start speaking. Their movements become appropriate. A 'high-five' has never meant so much to me...

Clearly, this is not the end; but maybe the end of the beginning? Or the beginning of the end? Something like that...

There really is hope. Who'd have thought?

1 comment:

emergencyemm said...

I like this post...

I've blogrolled you.