This week, we started our duty in the ICU. RLE groups were split, half will have their duty in the Medical ICU, half in the Surgical ICU. I went to the MICU group under Sir V.
This 3-day MICU first exposure was kind of hard and different for me. One of the many reasons I was very anxious was the fact that ICU was a whole different story. I haven’t seen the setting, I haven’t seen how toxic the patients were thus I don’t have any idea how to deal with my future patient. I have no idea how to deal with toxic patients in the first place. During my previous rotations, I was usually assigned with the less toxic patient, the one who was about to be discharged, the one who has no meds to begin with (thus no drug study), the one with no IV, no foley cath, not a single contraption.
To get to the story, I got the toxic patient in the MICU. Okay, not really super toxic, it’s just that I got the patient with the volume respirator plus that she was unconscious.
To get a clearer picture of my patient: Patient X, female, 45 years old; chief complaint: sudden loss of consciousness; impression/dx: CVD bleed vs infarct brainstem area; a couple of meds (hmm, 16 or something plus the PRN); GCS of 6, with NGT, with endotracheal tube, attached to volume respirator, with IVF of PNSS 1L x 100 cc/hr, with AC drip, with foley catheter.
Let’s go straight to the second day when we had our full blast activities. She had not opened her eyes, had not been responding verbally, but withdraws to pain. The AC drip had been used up, no meds available except for one amlodipine, one catapres and three captopril. With my 8 o’clock vital signs, her BP was 190/110 and T of 39 something. I’ve given the OTF (my first time! But I’ve discovered I loved doing it!) then gave the catapres. Then I’ve done TSB (first time too! Gosh…). All throughout the shift, her BP ranges from 170-190/100-120 and temperature swinging back and forth with a minimum of 39.2. During the first day, I’ve noticed her daughter coming in. During the second day, I saw her on the waiting area and approached her asking for the meds. She told me she had not bought any. Then some time later, she entered the ICU. I updated her with the condition of her mother and asked again about the meds. She was telling me that buying the meds would not make a difference because she was worse. Also, she doesn’t like going in there because she can’t take it, looking at her mother in that condition. Then there’s this time when 2 relatives came in. They tried to wake her up and all but then they can’t. So I approached them and told them her status, based on the GCS, of course explaining it in layman’s terms. Somehow, I felt happy when they looked hopeful, tried to talk to my patient encouraging her. I can’t explain what I really felt but I know I’ve felt something, thinking that there are at least people who want her to live.
Fast forward to the next day, a guy visited her. He said she was her ‘nobya’ or girlfriend. Tell me if it’s wrong or not but I asked further. Then I’ve learned he and my patient were not married because he had a family. My patient’s daughter was not his. He lives with his family, but he loves her, and his wife knows about his relationship with my patient. He really emphasized to me, ‘teh anhon mo hay siya gid akon palangga,’. He also told me that he can’t do more about it even though he loves her so much because my patient’s daughter was against it. But then he told me that my patient’s daughter who was against the relationship was even the one who called him and had given him permission to come and see her mother. Then he was telling me how much love can do. He was talking to her and he was telling me she had moved her eyelids when he talked to her. Then before he went out the unit, he whispered to her, “Bato ka…”, encouraging her to fight it (her disease), be strong.
This day, there were meds already, though not all, her BP had not gone up to the point of a PRN drug needed but her temperature was still high, though it was going down but on the minimum of 37.8, going up every now and then, so I still had to do TSB. My patient’s daughter then went in again and I’ve informed her about the BP and temp lowering. She was doing something already to buy the meds with help from different people.
My point with this experience?
Life, love, struggle to survive, struggle to believe…
That sometimes, we become the daughter. We can’t stand looking at our loved ones suffer. Sometimes, no matter how much we love these people, we just want to give up. We would like to stop believing but then there will always be a little percentage, no matter how small it always counts, of hoping of a miracle.
That sometimes, we become the boyfriend. Love surpasses everything. Love believes, love gives strength. Love does not give up.