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Things I've noticed while visiting the ICU

trevorklee.substack.com

181–190 of 387 posts

Re: Things I've noticed while visiting the ICU

#181

Surgeon here. I'm about more surprised by the discussion here than from the article itself. > 2. There are many consults, but the ICU attending is king (or queen). There's a concept called doctor's autonomy . The attending physician has the primary "guard" of the patient care, so unless dynamics of power, consultations are more like suggestions than law. So, the final care is generally dependent on the attending phys…

From an epidemiological perspective, one of the hardest things about evidence for critical care is that ICUs are really, really hard places to conduct studies.

Re: Things I've noticed while visiting the ICU

#182
What he wrote about delusions and nightmares in the ICU really hits close to home. When I was younger I ended up in the ICU for an accidental poisoning. Initially I went in and out of consciousness, having horrific nightmares fed by the morbid happenings around me. We had many interesting patients come through the ICU. One person was there for a suicide attempt on prescription drugs. Another person had been in a car accident. At one point we even had a prisoner who had been stock-piling drugs to kill himself on. They had him hooked up to a dialysis machine which apparently works well when the drugs aren't fat soluble? It was like a real life episode of House.

Meanwhile I wasn't mentally doing that great. When I was finally conscious I started hallucinating and hearing voices. I was hearing insults from the staff that weren't there and felt like everything was done with malicious intent. It was quite traumatic. I actually remembered these delusions for years afterwards and had trouble accepting that it wasn't real. It's only been a recent thing that I've even been able to speak about such experiences without shutting down emotionally. The work that doctors and staff do at ICUs is extremely valuable. But it's definitely not a great place for a vulnerable mind.

I feel like there is more that could be done in such a situation. e.g. where someone is profoundly hallucinating. I was over-stimulated and noise was making everything worse. If I just had of had a dark room to recover in I probably wouldn't have been traumatized. Maybe even ear plugs or a mask. But I didn't even have that. I'm also kind of surprised by the OPs story because the ICU I was in was like this closed surgical ward filled with medical staff. ICUs don't really seem like a place to have visitors. I get the feeling many people there aren't even going to be conscious. OPs dad is lucky to have had such good family support.

Re: Things I've noticed while visiting the ICU

#183

Earlier quoted context omitted.

Funny, I pay even more than you mention to support my own mother in relative comfort in a nursing home, and I don't find it "painfully easy" to think that way at all. I certainly don't hope she dies tomorrow. You might want to reconsider saying such things in public. Note: my mother, not my grandmother, and I have lived that ordeal for several years. Some interaction is still possible, but recognition has been beyond…

Before you jump the gun like that again: The context is most likely about the suffering of the patient in question from simply existing in that state, and there being no way to alleviate the suffering (only prolonging the life). Not about saving money. So it’s a lose-lose: the patient suffers and society has to pay for their privilege to suffer (without recourse, most likely). And maybe you disagree fundamentally wit…

Before you jump the gun again...

> Not about saving money

Then why even bring it up, let alone cite it as something that change[ds] one's views?

> maybe you disagree fundamentally with things like assisted suicide

In fact I do not. There was a time when my mother wanted to end it, and I wasn't the one who stopped her. I respected her right to make her own choice. Her condition subsequently improved to the point where she no longer wished that, leading to the current status quo, but that's already far more than any of the pissants in this thread deserved to hear about it. Expressing one's own wish for a supposedly-loved one to die is indefensible, even if they also wish it for themselves.

Re: Things I've noticed while visiting the ICU

#184

I noticed a lot of the same things when my dad was in the ICU. Some additional thoughts: 1. "Almost every patient has delusions and nightmares" I personally felt "off" when visiting my father. The sounds, smells, lights and constant buzz of activity all contributed to a feeling of being in a surreal dreamworld. Lack of sleep contributes. I can't imagine what my father experiencing. 2. Food was HORRIBLE. One meal was…

Yes - my wife is a physician and she routinely describes how well meaning family members make care harder for their loved ones by trying too hard in the wrong ways. Requesting more care doesn’t get you better care - “squeaky wheel gets the grease” doesn’t really apply in many situations.

Re: Things I've noticed while visiting the ICU

#185

I noticed a lot of the same things when my dad was in the ICU. Some additional thoughts: 1. "Almost every patient has delusions and nightmares" I personally felt "off" when visiting my father. The sounds, smells, lights and constant buzz of activity all contributed to a feeling of being in a surreal dreamworld. Lack of sleep contributes. I can't imagine what my father experiencing. 2. Food was HORRIBLE. One meal was…

I had a family member who wasn't even in ICU, and still experienced delusions simply from being sick and being in the hospital for a few days. He thought there was a group of family members around the corner waiting to jump out and surprise him and was insistent that I tell them not to disturb the other patients. I had to argue with him to get him to accept that, no, there is not a random group of family members waiting to jump out. He insisted he heard them talking and stuff. It was pretty disconcerting for me actually because he has always been a psychologically-bulletproof person. Definitely an eye-opening moment for me.

Re: Things I've noticed while visiting the ICU

#186
I have been in the ICU and can relate to the hallucinations.

During one intense round, I was convinced the hospital wasn't real, and that I needed to leave immediately.

My IV was preventing me from leaving, and I couldn't have that.

So of course I ripped it out and tried my best to leave. The staff wasn't having it.

Re: Things I've noticed while visiting the ICU

#187

I have been in the ICU and can relate to the hallucinations. During one intense round, I was convinced the hospital wasn't real, and that I needed to leave immediately. My IV was preventing me from leaving, and I couldn't have that. So of course I ripped it out and tried my best to leave. The staff wasn't having it.

You thought it wasn’t real as in you though everyone was an actor in a fake hospital building or you thought you were in a whole nother plane of existence?

Re: Things I've noticed while visiting the ICU

#188
post #138

Earlier quoted context omitted.

> I also pay taxes Do you really get nothing ? And who is paying for whose care? You mention taxes, but they've probably been paying taxes even longer. And why do you think health care is a strict quid pro quo anyway? Some of us believe care should be allocated where it's needed, not where it's paid for. Put another way: why is it a problem that they are getting care? Isn't it that you aren't ? This doesn't have to b…

I wish we (Americans) had universal healthcare, but at this point I'm pretty jaded about that ever coming to pass. So I agree with you there, and your point about them having paid taxes is also a good one. That said, we do care for the elderly because of their vulnerability but we then shit on younger disabled people. Old people can have assets, most younger disabled people can't, and younger disabled people can lose…

> am I just supposed to suffer and accept I matter less than an old person?

Absolutely not. The situation is deplorable, and I hope we can get to a better one some day. Fight for all you're worth. All I'm saying is that others who receive care are not your enemies. (Or at least not because they receive care. There's bound to be some overlap.) The enemy is the people within the system who restrict the labor supply, drive up prices for everything else, make arbitrary rules like those you've mentioned, and so on. The politicians and profiteers, not the patients, define that system.

Re: Things I've noticed while visiting the ICU

#189
post #187

I have been in the ICU and can relate to the hallucinations. During one intense round, I was convinced the hospital wasn't real, and that I needed to leave immediately. My IV was preventing me from leaving, and I couldn't have that. So of course I ripped it out and tried my best to leave. The staff wasn't having it.

You thought it wasn’t real as in you though everyone was an actor in a fake hospital building or you thought you were in a whole nother plane of existence?

Interesting question ... plane of existence.

I was hearing voices that convinced me I was not where I thought I was, it was an illusion of sorts and it was best to leave. Immediately. For reasons unclear to me.

Re: Things I've noticed while visiting the ICU

#190
post #84

Earlier quoted context omitted.

"Warehousing her body" suggests otherwise. When people talk about someone as a "body" they usually mean insensate IMX. People whose loved ones are in pain tend to use different, even more colorful, language. I know I did, when that was the case.

> People whose loved ones are in pain tend to use different, even more colorful, language. The human experience varies wildly and I would not make such assumptions. Caring for somebody without the hope of improvement for years can make you bitter or even resent the person that no longer resembles the one you loved.

> make you bitter or even resent the person

And that's OK? I happen to think it's not, that bitterness and resentment hurt everyone involved, and I know that it's possible to resist those feelings. How, exactly, does the person who succumbs get to play Good Guy?

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