Assalammualaikum.
As an Anaest MO, I work in both the Operating Theatre (OT) and the Intensive Care Unit (ICU).
Needless to say, the patients I treat in ICU are all very sick patients. Most of the time, they are intubated, to allow oxygen being delivered to them so that they can breathe better, and easier and thus, relieving their bodies of the fatigue.
Often, we managed to save them.
They recover, extubated and then discharged to the general (normal) ward.
Sometimes they don’t do well, and we need to know when to stop, and when to say “OK, this is it. This is our limit and there is no more we human beings can do”. It is challenging to determine that point. I am always scared that I gave up too early. What if I just need to try a bit more to save him?
Often, the line separating surviving from succumbing is grey.
And adding to the complexity - is the life after survival.
One might survive the ordeal but left with disabilities that render him / her dependant on others.
One might get through a severe infection of the lungs but the heart became weak and can't even stand walking to the toilet without feeling breathless.
I would often think - would the patient rather die of the infection or live with permanent disabilities? How can we know? Will the children know?
Jangan menambahkan penderitaan seseorang / tak nak dia menderita lama
So what if we can save the patient, but we know the outcome will not be good? Should we still try all out and get the patient to live - but only having his heart beating but without his brain and muscles functioning well?
And then comes miracle. How sure can I be that no miracle will ever happen?
Families cling to the word miracle like a stranded hiker clinging on her fingernails.
They need it, they desperately hope for a miracle. And I am there, shattering all their hopes.
Yes, I believe in miracles. But that is specifically why they are called miracles.
They rarely happen. And if they happen, no matter what we did, it will still take place.
ICU is a very specialised and thus, limited place.
Not all patients can be admitted to ICU - we need to choose our patients carefully, those who can benefit the most from an ICU admission and we have our own admission criteria.
Some patients who unfortunately do not meet the admission criteria; will be ventilated in the general wards. And it breaks my heart seeing these patients being outside in the normal ward, and die eventually. I usually hope the families will bring them home, so that they can die at home, surrounded by their family members.
But our society don't really do that.
They'd prefer their parents to die in the hospital, and most of the time, they don't agree to the withdrawal of care. They will agree to at most, limitation-of-therapy.
Every critically ill patients have a story of their own.
They might be healthy and fit last week, but a severe infection of the lungs, or perhaps disseminated infection of bacteria into their spleen and livers, causes them to be incapacitated and fighting for their lives.
Sometimes, it is a motor vehicle accident - injuring their intraabdominal organs, their brain and/or their bones.
Critically ill patients can be any of us in the future.
Have you actually thought about it?
Would you prefer being alive but disabled permanently and relying on your family members or die trying?
Is life, or quality of life more important to you?
p/s: No I am not trying to say people that are already disabled to be better off dead. No no not at all.
It's just so hard to imagine living but not really living. You aren't even yourself anymore.
-Because life is a test-
-AkMaR-
http://nur-akmar.blogspot.com
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| ICU settings |
As an Anaest MO, I work in both the Operating Theatre (OT) and the Intensive Care Unit (ICU).
Needless to say, the patients I treat in ICU are all very sick patients. Most of the time, they are intubated, to allow oxygen being delivered to them so that they can breathe better, and easier and thus, relieving their bodies of the fatigue.
Often, we managed to save them.
They recover, extubated and then discharged to the general (normal) ward.
Sometimes they don’t do well, and we need to know when to stop, and when to say “OK, this is it. This is our limit and there is no more we human beings can do”. It is challenging to determine that point. I am always scared that I gave up too early. What if I just need to try a bit more to save him?
 |
| Give up? Or try harder? |
Often, the line separating surviving from succumbing is grey.
And adding to the complexity - is the life after survival.
One might survive the ordeal but left with disabilities that render him / her dependant on others.
One might get through a severe infection of the lungs but the heart became weak and can't even stand walking to the toilet without feeling breathless.
I would often think - would the patient rather die of the infection or live with permanent disabilities? How can we know? Will the children know?
Jangan menambahkan penderitaan seseorang / tak nak dia menderita lama
So what if we can save the patient, but we know the outcome will not be good? Should we still try all out and get the patient to live - but only having his heart beating but without his brain and muscles functioning well?
And then comes miracle. How sure can I be that no miracle will ever happen?
Families cling to the word miracle like a stranded hiker clinging on her fingernails.
They need it, they desperately hope for a miracle. And I am there, shattering all their hopes.
No, please don't hold your hopes high. You need to understand, your father is not doing well and his heart might give way anytime soon. Please be ready.
Yes, I believe in miracles. But that is specifically why they are called miracles.
They rarely happen. And if they happen, no matter what we did, it will still take place.
ICU is a very specialised and thus, limited place.
Not all patients can be admitted to ICU - we need to choose our patients carefully, those who can benefit the most from an ICU admission and we have our own admission criteria.
Some patients who unfortunately do not meet the admission criteria; will be ventilated in the general wards. And it breaks my heart seeing these patients being outside in the normal ward, and die eventually. I usually hope the families will bring them home, so that they can die at home, surrounded by their family members.
But our society don't really do that.
They'd prefer their parents to die in the hospital, and most of the time, they don't agree to the withdrawal of care. They will agree to at most, limitation-of-therapy.
Every critically ill patients have a story of their own.
They might be healthy and fit last week, but a severe infection of the lungs, or perhaps disseminated infection of bacteria into their spleen and livers, causes them to be incapacitated and fighting for their lives.
Sometimes, it is a motor vehicle accident - injuring their intraabdominal organs, their brain and/or their bones.
Critically ill patients can be any of us in the future.
Have you actually thought about it?
Would you prefer being alive but disabled permanently and relying on your family members or die trying?
Is life, or quality of life more important to you?
p/s: No I am not trying to say people that are already disabled to be better off dead. No no not at all.
It's just so hard to imagine living but not really living. You aren't even yourself anymore.
-Because life is a test-
-AkMaR-
http://nur-akmar.blogspot.com
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