It was another simmering-hot Texas day, and the AC was faltering in the family-practice clinic where I worked as a family nurse practitioner. Most of our clients were poor and spoke only Spanish. My nurse, Eliza, approached, wide-eyed. “ThereR…
Category: Critical Care
Go quiet into the night
I know what you’re thinking: She’s cold-hearted, cruel, and unkind. But am I? Or are you? Grandma Lilly is 87-years-old and in the ICU. She’s on a ventilator with her wrists restrained to the side of the bed. Grandma can barely see because her eyes are…
Treating the patient’s body is not synonymous with treating the patient
We recently had a patient who arrived on our service in the intensive care unit after a complicated surgery. The surgery left him close to dying, and he was immediately put on life support and given heavy sedatives. Ventilators breathed for him. Specia…
What a kitten taught me about critical care
I recently read an article entitled “The family said, ‘Do everything.’” It described the case of an elderly patient at the end-stage of life. The article concluded that “If your loved one has reached an end-stage of life, do the right thing. Let them d…
The evolution of the stethoscope
The stethoscope. Nothings says “I’m a doctor” more than the stethoscope in a pocket or draped around the neck. Forty-five years ago when I got my first one, a gift from my physician-father, the former was more common. Then we were more likely to wear c…
Your greatest role as a doctor? Storyteller.
There are medical honors so rare you don’t even know they exist. When you’re trudging through the slog of PBK/AOA/other — ultimately meaningless — letters, these seem to be the definition of distinction. Just like every other lesson, a patient taught me what real prestige is. Well, it wasn’t entirely that Oslerian, it was the […]
A physician loves the adrenaline surge
Have you ever felt so cold? I mean bone-chilling cold. I don’t mean the same kind of cold that northern winters can leave you feeling. I am talking about working in a hospital that is climate-controlled, and you are undoubtedly shivering. I still remember my first day on the job as a neonatology fellow. I […]
Sometimes the most I can offer is to be present with people
I’m sitting in the ICU team room, staring at the computer, trying to look like I’m writing a note. But my head is pounding. As an internal-medicine resident doing my first month of residency, I’ve found the ICU of the bustling county hospital a jarring place to start my training. Although I’d anticipated the clinical […]
With every hardship comes ease
“Where is my baby?” I awoke upset that my belly, which hours before was bulging through my doctor scrubs, had surprisingly been flattened. No one had asked for my permission to deliver my baby. They told me he was delivered emergently — at 32-weeks gestation — to save both our lives. I was a third-year […]
Delirium is a serious and common outcome of treatment in hospital intensive care
Since intensive care units (ICU) were created in hospitals more than a half a century ago, there has been a steady decline in death rates for individuals who are critically ill and require life support. That’s significant and meaningful progress, and it’s thanks to the pioneering work of many doctors, nurses and researchers who have discovered better […]
