Saturday, April 11, 2009


I am stuck in a place of being very uncomfortable with my current situation. Its not that I don’t “like” the people that I work with. I just don’t like working in the ICU (intensive care unit) during part of the intro I learned that 20% of deaths in America happen in the ICU. I may vent and say that I don’t like it, but it’s the whole situation. Perhaps it is just right to say that I don’t like it. Grrr. I don’t want to say that I do not like it, but I don’t.

A few days ago I got to meet an old guy who came in because he could not breathe. Classic COPD, old military vet, big chest, no lung space. Looks super bad on chest x-ray, all full of fluff and fluid, his heart is big (not a good thing). He has a DNR/DNI its an order to not do chest compressions or intubate him. Its fairly common, lots of people do not want to live life hooked up to 20 machines with a big tube stuck down their throat. Well, during morning rounds, he was crashing, he was at the end, he had had a HUGE heart attack and his lungs were filling up with fluid because his heart could not keep up any more. We all knew that he was a DNR, we had spoken with him many times during the night and he was very adamant that he did not want tubes and mechanical ventilations, he did not want chest compressions, he did not want to be shocked.

The head doc who had just come on shift comes in and tells him that “You have had a big heart attack, the only thing that we can do to help you is to put a tube down your throat to help you breathe. Is that what you want?” The man agrees and we intubate him.

He is now “living” with a tube down his throat, one in his nose, two lines in his arms, an arterial line in his wrist, and a central line in his femoral vein. We have 8 different drips set on him. His lungs are shot, his heart is not working, his kidneys are shutting down, and he has a massive infection.

The more I think on this, the more it bothers me. Sure we “saved” his life. But is that a good thing? The man was drowning in his own lung fluid and could not breathe! What did we offer him? The only thing to do is to put a tube down your throat. What the FUCK!? Of course he would take that. I will never forget what it looks like to watch a man drown in his own lung fluid. NEVER. Its not a good thing.

The thing that has been bothering me is that we did not offer an alternative. All the interns and residents KNEW he was DNR. He was 86 years old and was OK dieing. He did not WANT to be tubed and have a billion lines run into him. I wish that we could just do it over again. What if we offered him some morphine to make him comfortable and just let him go??? But NO, we have to push and push and push and sell him a fucking tube. Who would be strong enough to say no to that?

I would not be.

I did not think that I would be this angry over “saving” a life, but I AM! I hate myself for being part of this system. I feel dirty.


Jen B. said...


Carrie said...

sending you lots of love!