Another Month In The ICU

Last month I was in the NICU, or the neonatal intensive care unit, at The Med. This month I am in the PICU, or the pediatric intensive care unit, back at LeBonheur. The hardest part about the PICU is the parents. The NICU is a unit of babies, the sickest are on ventilators and under incubators. It is just one big room basically. The parents come once, maybe twice a day to visit if their child is there for a long time. I see them maybe a couple or three times a week. To be honest the babies are so small that they mostly all look the same. But in the new LeBonheur, the PICU is set up as individual rooms now. The family is almost always present. Walking down the hall you see every single family member watching over their child, passing them multiple times per day. You wake them up to talk to them in the morning. You interrupt them from reading their Bible in the middle of a Sunday morning. And you see them worrying, hurting, and grieving for their child. And it's the hardest thing in the world. In the ICU a lot of patients are too sick to interact or they are intubated and on the breathing machine with medication to keep them sedated. Therefore interaction is mainly with the parents. Several families have been there just about the entire month that I have been there so far. They are faithful in staying by their child's side.

Then there are days like today which are harder than any day that I could imagine. As soon as I walked in the door this morning I was right in the middle of a very critical situation. A family had literally just watched their child become neurologically devastated right before their eyes. Much of the day was spent speaking with them and explaining the grim prognosis. There were multiple times throughout the morning where it was hard to deal with things. Then there were rounds. I was trying to present my patient when I became too overwhelmed to speak and had to just stop talking to prevent myself from crying in front of several doctors, nurses, pharmacists, and respiratory therapists. The attending gave some short teaching points and I was able to recompose myself and complete my presentation. Later in the day more family arrived and I spoke with them. Somehow I am able to tell them that a child is dying.

It has been a good month. I have had the opportunity to make many special relationships. A couple of weeks ago one of my patients was having an operation. He knew his mother would have to say goodbye at the door to the OR, so he asked that I come with him into the operating room since I had access as an MD. There is a family I have been taking care of for the past week with a newborn named Allie, just like our Allie. There was a family of a boy who had a kidney transplant last week who I grew close to just from the frequency I had to check on him. Then there's the family that I talked about above, and especially that patient's little brother, who just happens to be the smartest and coolest 11 year old in the world. I think he truly understands what's happening on a medical level more than anyone else in the family. And then there are also missed opportunities. There is another family who I have taken care of all month who I haven't been able to form a bond with no matter how hard I try.

I have learned a lot of medical knowledge this month. But even more I think I have learned a lot about taking care of patients, families, compassion, relationships, humanity, and God. I know these are things I can take with me even if I am never in an ICU setting again and never have to know how to put in an arterial line or the dose of a sedating medication. Once again I have realized how special an opportunity and obligation I have been given in taking care of other humans and particularly other people's children and the trust that entails. I am once again reminded that I made the right choice in choosing Pediatrics for my profession. Now to decide what field to go into from here.