Tuesday, October 21, 2008

My Last ICU Visit

I met my new intern and resident yesterday. The new intern is really cool. He is going to be a neurologist, and he's another intern who loves teaching. Considering how bad my neurological exam is, I can use all the help I can get. Our first call together as a team last night was fairly uneventful, and we all got to go home early today since we are post call. But I only got a few hours of sleep last night, and overall I still feel pretty cranky and even a little bitter about the whole overnight call thing. Q4 call (every fourth night) sucks. You're always either on call, about to go on call, just getting off call. I have decided that I don't want to do any residency that requires Q4 call.

As promised, I stopped by the ICU on Monday last week to see my heart failure patient. I went into his room to find him intubated and sedated. Over the weekend, he had coded. When I went into the room, I pulled one of the chairs next to his bed and held his hand. I asked him to squeeze my finger if he could hear me, and he did. Then we just sat together like that for a while. For the rest of the week, I came in every day to sit with him for a few minutes, and every day he squeezed my finger when I asked him to let me know if he heard me. During one visit, his nurse saw me sitting there and asked if I was taking his pulse. “No,” I said. “I’m just holding his hand. He knows we’re here with him.”

Today, I got to his room just after a code was being called off. He had arrested again, and this time the code team hadn’t been able to revive him. Everyone had left except his son, who I had never met before. He asked me if I had brought the papers for him to sign. “No,” I said. “I’m a medical student. I came here to see your father. I’ve been coming to see him every day.” The son said something about how his dad didn’t want to be kept alive on a machine, and thanked me for taking such good care of his dad. Then he left me alone in the room with his dad's body to go searching for the paperwork.

At first, I was really put off by his seeming lack of emotion, as well as the fact that he had not ever come to visit his father in the hospital. But everyone deals with their grief differently, and maybe that was what he had to do to cope. At any rate, I am glad that I had the chance to know his dad, because he was a really great guy.

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