Wednesday, January 27, 2010

Critical Thoughts

It has been much too long since posting an update. Now I am graduated from med school (officially Dr. Peppers!) and I am 7 months into my intern year in med-peds at Indiana University. I spent my first four months on pediatrics, and now am finishing my 3rd month of a four month stint in internal medicine. Currently, I am finishing my ICU rotation.

What I have learned about medicine in the ICU is that if you take care of a patient's basic physiology, that is their basic biological processes, they will either heal themselves or not. Those who get better tend to do so of their body's own accord. Medicine is simply a means of preventing the processes that are 'damaging' the body from continuing to spiral out of control to the point of causing death or further injury. It is incredible what the body can bounce back from after serious illness. It's also heartbreaking how impossible it is to reverse some irreversible damage, such as a massive stroke leading to a coma, or the prognosis after a major cardiac arrest leaves the brain permanently damaged after being starved of oxygen.

Also, I have learned that the skills in talking to patient families that have come in handy so much on peds come in handy daily in the ICU. In the frequent cases that patients are critically sick, on a ventilator, and not able to interact with us, we tend to interact primarily with the family members and treat them as the patient's proxy.

The work is interesting, and exciting, however the on-call shifts lasting 30 hours tend to go without a chance of rest even for a minute. I don't think I ever knew exhaustion could reach such depths.