I’ve officially survived my first week in the ICU!  I wish I could be happier about it, but I’m really just exhausted, and I coming down with some kind of bug.  I don’t even want to think about the different infectious organisms I’ve been exposed to in the ICU because I really could be coming down with about anything – including Aeromonas from leeches!

The ICU – which stands for Intensive Care Unit – is a totally different kind of clinical rotation.  As the name implies, it is reserved for extremely sick patients who either require some kind of respiratory support with mechanical ventilation, blood pressure support with pressors and fluids, or some other intensive care.  For instance, we sometimes see patients who have had recent surgery but need special care by a medicine intensivist that a surgeon can’t manage.  One of our patients had to have a skin flap placed over a wound and is now getting round-the-clock leech therapy to help increase blood supply to the tissues.  It’s pretty cool….but also pretty disgusting.

I’ve already decided I’m not going to count how many patients die during the month I’m here.  I try not to think about it.  I’m just glad that so far I haven’t been around to witness it.  But the ICU is a fairly depressing place.  Some patients are surrounded by distraught family members who are crying or praying over them.  While others are completely alone and have no family to visit them.

However – despite the chaos and the depressing condition of the patients, it’s a great place to learn medicine.  As my attending says, “If you can manage ICU patients, you can manage any patients.”  Every day is a wealth of knowledge in the ICU.  It can be a little overwhelming at times.  I’m finally getting comfortable with all the lines and tubes coming out of the patients.   I was blessed to have an attending go over every line and tube and what it was used for.  Believe it or not they never taught us that in medical school!

Even though it’s interesting, I really don’t like the ICU.  I can confidently say I won’t be specializing in Critical Care.  I don’t like that the patients are so sick.  It can be very scary at times.  And I absolutely hate that as soon as they start to improve, we ship them out to a regular floor.  So really, you never get to see how much better people get.  And I think the hardest part for me is having to talk to the families.  Most of the families don’t understand the gravity of the situation that their loved one is in.  The doctors will try to be as blunt as possible, but it’s just hard to see them hanging on to false hope.

I’ve said it before and I’ll say it again – I absolutely love the hospital.  I can’t imagine working anyplace else.  But when I die, I hope it is anywhere but the hospital.  I really can’t imagine a worse place to die than in the ICU hooked up to a million machines and surrounded by a bunch of strangers.  And please, please never let them use leeches on me!