This post is a novel. You have been warned. I'm also warning you that the internet says the singular "they" is ok.
Recently, I have had occasion to spend a lot of time at a hospital, maintaining vigil over an ICU patient. Every hospital has different facilities of course, but unless you're a hoity-toity fancy-pants who can afford one of those hotelesque "recovery centers," chances are those hospital facilities do not include overnight accommodations for the ICU patient's family representative or caretaker.
The hospital I was at was one such place. Like most hospitals, there are spots where, while sleeping overnight isn't exactly encouraged (as this would probably attract genuine vagrants), it also isn't prohibited. Sometimes, you are far from home and cannot afford a hotel. Sometimes, the procedure that put your patient in ICU to begin with went sideways and you have to be nearby for legal/proxy reasons or want to be for filial ones. Sometimes you have been there since 4:00 AM and your patient didn't get stable until 1:00 AM and to try to drive home at that point would invite fate to put you in ICU right next to your person. So you're staying. For a small dose (lol medical puns) of each of these reasons, I stayed for a few days. And as I am wont to do as a woman some of my teachers described as "curious" (right after "female" and "arguably literate"), I learned things.
Sleep is a Battlefield
Become a Marine when it comes to sleeping: adapt and overcome. You will probably have a couple of options for sleeping locales and they will all be terrible. I labored under the delusion that I could pick a spot and remain relatively undisturbed through the night...but ICU families are often in states of emergency, consumed by nerves and fear and can't help but chatter, move around and try to make each other laugh to alleviate the weight of dread.
Your brain says this to you. Your heart says things like, "No but seriously I was here first, do you not see me? Do you not see me laying here very obviously trying to sleep? Do you not see the greasy hair and puffy eyes and pit stains that suggest I've been here multiple nights? OPEN YOUR STUPID EYES AND SHUT YOUR STUPID MOUTHS. I hope you step on a Lego barefoot."
You learn that the loud families are first-nighters and recall that you were loud and nervous and antsy your first night, too. And then you learn that the quiet families are expecting or experiencing profound loss right there next to you while you read your Cracked articles on your iPod, after which point your heart stops complaining so much.
Beep boop
ICU makes sounds. As it turns out, some of what TV shows you happens when a patient has a heart irregularity is accurate. And by "some", I mean, "the pitch, timbre and occasionally the meanings of various sounds a heart monitor makes." I heard my patient's monitor make a specific sound and immediately heard a TV doctor in my brain say, "She's in V. Tach!" with panic. I looked up and, sure enough, a little red box appeared in the corner of the monitor which read "V. Tach."
What did not happen next was an influx of doctors and nurses with shock paddles shouting "CLEAR!!" and "PUSH 5 MILLIGRAMS EPI STAT!!!!" at each other and a mentor/authority figure looking at an underling with contempt. What did happen next was that the sound stopped after three seconds and the nurse didn't even look up from the computer.
Being in ICU during the day made me familiar with many monitor alarms - I came to learn the specific ones for V. Tach (entry knowledge, as it were), regular Tachycardia, blood pressure spikes or drops, rhythmic errors (lol i'm a music teacher) and mechanical problems like an ECG lead popping off. These usually warranted only a brief glance from the nurses or doctors to see if they resolved themselves, which they almost always did. I heard other patterns from neighboring patients' monitors, but since my patient never triggered them, I don't know what they mean. I also never heard the famous "flatline", the popularly-supposed sound of which might be a TV myth anyway - doesn't seem like a good idea to me to make it known to neighboring patients and families that someone's heart has up and stopped.
Vocal tones from ICU also stand out to me. By and large, ICU doctors and nurses are the picture of composure. They remain positive during periods of progress or stability, calm and matter-of-fact during problems or crises. Some choose to remain dry and almost standoffish at all times, probably so that they don't alarm the patient with a change of affect if something goes awry. There was one exception: when someone was being awakened from anesthesia or long-term sedation. I realize that it's a delicate situation, that surgery is a big deal and the sooner we can ascertain a patient's well-being, the better...but I am at a loss to describe how funny it is when in the middle of this highly professional and efficient environment, someone starts yelling, "HEY THERE! CAN YOU WIGGLE YOUR TOES FOR ME? WIGGLE YOUR TOES. WIGGLE YOUR TOES." [pause, calm instructions to nurses] "CAN YOU TELL ME YOUR NAME? WHAT'S YOUR NAME? SAY AGAIN? GOOD. WIGGLE YOUR TOES."
Et cetera. My patient took to wiggling their toes at each command in solidarity.
Feed Me, Seymour
I abandoned vanity in favor of resource optimization when it came to food. The first couple of days, I was too emotional to eat much and required reminders from family. After that, family members put together a care package for me with some of my preferred foods so I didn't have to keep spending money in the cafeteria. The vending area included microwaves and sporks, so I took my cans of soup and bags of veggies in there and sat on the floor in the corner of the room.
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New Friends
I am always fascinated by temporary communities. When you're only spending a few days with a group of people, but you're around them all day long, you start to form a mini-society. It has happened to me three times this summer: once in New York at IB Music training, once in College Park at AP Music Theory Training, and with the ICU families. We compared patient stories, shared strategies for diet, sleep and hygiene, watched each other's stuff when someone needed to run to the bathroom or cafeteria, and prayed. Oh the praying. This hospital, like most, had a chapel onsite, but I'm pretty sure God's mail pile from ICU waiting was several feet higher than that from the chapel.
I mentioned above that some nurses and doctors preferred to keep a professional distance, which I completely understand. There were a few, though, who were comfortable getting personal and were truly Godsends in my time of need. Even though what my patient experienced was not really unique and certainly not cause for alarm for any of them, these doctors and nurses could tell how afraid I was due to my ignorance and inexperience and they took the time to learn my name, to explain things to me so that I could understand, to map out their plan As and Bs (particularly once word got out that I'm a teacher), and to give me tasks when they could so that I could feel useful. I kept a running list of all of their names and wrote them all glowing praise on my feedback card.
Three Days to Orient
I read about (and then heard about on an episode of Bones) a study wherein people were given special eyewear that made them see upside down. At first, they stumbled around all confused, but after three days, their brains adjusted and they saw the world right side up with the eyewear on. After a week or so, the eyewear was taken away and their unadorned eyes once again saw everything upside down. Three days later, all sorted again.
The day of my patient's procedure and subsequent admission to ICU, a couple of things happened that, while perfectly treatable and not emergencies, extended my patient's stay in ICU and deviated from the original planned timeline and procedure for recovery.
What the surgeon said to me (edited for privacy): "This organ is still having a little problem functioning on its own, so we're going to use this mechanical device to supplement it and let it rest a while. This happens sometimes - the organ's been through a lot and it just needs time to adjust. But we accomplished what we set out to accomplish with this surgery!" This was delivered in a calm and positive tone of voice.
What I heard: "This vital organ is broken. Death is imminent."
I had already cried twice at the reality of my patient having the procedure to begin with; this news set me off again, as did the sight of them in ICU for the first time with so many IVs and tubes. For the rest of the night, it was like I had a hormone imbalance...
Sister: "You want to go get a bag of chips?"
Me: *10 minutes of abject weeping*
A day later, I had briefly left the hospital to do some things at home and get some rest while another family member stayed with my patient. I had been asleep about an hour when the family member called saying the repaired organ encountered another quite common, quite treatable issue, but one I had never really heard of or knew anything about. At this news, I rushed back in a state of hysterics.
What the doctor said to me: "This organ is having this small problem. We're fixing it with this drug, and we have another solution if the drug doesn't work."
What I heard: "This organ is having myriad problems. It will never work normally again. Your patient will be an invalid, if indeed they survive the night."
More random crying jags.
Family member: Hey look, Clay Aiken is on TV.
Me: *grabs 8 tissues to absorb all the tears*
But by the third day, things were shifting. The first problem resolved itself, but the second one returned a couple of times during the third day. I felt less fear each time, finding it nearly routine by day's end. That night, I again went home while a family member stayed with the patient.
Family member called the next morning to tell me that the problem persisted and they were moving ahead with the slightly more drastic, but also more effective, Plan B. I took the phone call in stride, drove back calmly and, as a result of the ICU folks running ahead of schedule, arrived after Plan B had already been implemented successfully. My patient was alert, happy, and continuing to net progress...which, in fact, they had been doing all along, but I was too blinded by ignorance and terror at the time to notice. Three days for an upside down world to become right side up.
Epilogue
My patient is now home and recovering well. Family and friends have rallied around them, sending food and gifts and helping with tasks...my patient has a great tribe. It was an emotional way to end the summer, but it beats sitting around my house feeling guilty for not being more productive leading up to pre-planning. Because as we all know, everything that happens to everybody is ultimately about me.
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