Things learned at the halfway point in the ICU

1) People do recover from the craziest things: had one old guy go comatose from a brain infection, then have a stroke, then have seizures, then get intubated for one week for respiratory failure, and right now he is sitting up in a chair in the hospital getting ready to go home

2) Never getting to sleep can make you really tired: I don't get to sleep anymore. Every third night, I am on call, meaning no sleep whatsoever. I get every sixth day off. My last day off, I slept 13 hours. Jam... good. Meat... good. Sleep.... gooooooood.

3) You don't see your friends or family as much: I'm told I'm married. There is a woman that cooks me dinner from time to time, and she does seem familiar to me.

4) Doing procedures can be scary: My first central line (a big honking tube you stick in someone's big neck or shoulder veins) was a subclavian line. The procedure for a subclavian line is that you feel where the patient's collarbone bends (about halfway out), jab a needle into it pointed at the sternum, and then literally push down on the needle until it slips under the bone. Scary things are down there, like big arteries and lungs. The first one I did the needle slipped a bit once I got under the collarbone and slid forward about an inch more than I wanted. Luckily, I had a clean pair of underwear in the call room.

5) Vets don't die: I've had three veterans under my care at this point, all three I was sure would die, and none of them have. You can't kill a vet.

6) Young people die: two of my sickest patients so far were a 37 year old that died about 18 hours after coming into the hospital with a heart infection, and a 17 year old kid that came in yesterday with a little flu bug that progressed over 24 hours to a multilobar pneumonia (infection all over the lungs). He got intubated. This was a 17 year old freshman in college, who had no other health problems. Kinda freaky.

7) Cases are only really cool when you don't have perspective: The forementioned 37 year old was a fascinating case. He got a bloodstream infection that set up on his heart valve, then shot off to his lungs, and then just crumped. We were pumping him fully of fluids and different meds, playing with the vents; we got echo upstairs and stared at a massive vegetation on his heart valve. It was all really cool, until the father came into the room crying, and we had to tell him that his son would probably die that day (he died about an hour after the conversation).

8) The nurses have definitely saved my butt a few times. They are pretty good up there in the ICU. Not like the first floor nurses at my medical school.

9) I am a medical god. Just call me Dr. Daman (just checking if you were still reading)

10) Did I mention I miss sleep?