Planet ICU

This month, I've felt like I've been living on another planet.

I've had five days off total this month.  Five short days.  Most days I've worked 12 hours.  Aaron has had long hours too this month on his pediatrics rotation, so my mom has been watching Julia for 11-12 hours most days this month.  I'm pretty sure God has a special place in heaven for my parents, because the amount of sacrifice my mom and dad make for us is incredible.  Saints, I tell you.  What love.

So, basically, it's been a pretty exhausting month for everyone all around.

And, in the twelve hours I'm at work, life is so different.

I rarely see the sun, because in the ICU, there are hardly any windows.  This planet is a dark one.

We speak a foreign language.  In the past 2 1/2 years, I'd gotten fairly used to Medical-ese, but the ICU has its own dialect with hundreds of new vocabulary words, including dozens and dozens of acronyms.

There is a distinct smell in the ICU.  I can't describe it, but if you're curious, all it'd take is one whiff of my white coat.  Every time I wash it, the smell returns after just one day in the ICU.  There are also many smells much worse than the baseline ICU smell.

Patients do get better and leave, but most of our patients are so sick.  I've seen a lot of death this month.  We see skeletal people, wasting away due to full blown AIDS.  Yellow people, bloated with liver failure, due to years of alcohol abuse.  Barrel chested people, struggling to breathe, after years of smoking.  Feverish, flushed people, fighting infection.  Altered people, struggling against the very people trying to save them.  Moaning people, battling severe pain.  Vacant people, unlikely to ever respond due to significant brain damage.  Blue people, coding and dying. 

I'm familiar with a lot of new procedures and devices.  I've seen how lines are placed in many different vessels, tubes in different orifices.  I know a decent amount about ventilators because many of our patients are intubated.  I'm familiar with dialysis, because many patients are in renal failure.  Familiar with crash carts and ambu bags because we respond to every code blue in the hospital.

I've had difficult conversations with distraught family members.  I've prayed with and held the hands of the dying.  I've rejoiced when patients have been discharged to the general medical floor.   I've been stretched in many ways.

When I leave the ICU, it takes me a little while to adjust to life outside.  Life outside can sometimes seem almost too carefree, too upbeat in the transition, like a bright light suddenly turned on in the dark.  It can take me a little while to decompress, to equilibrate.  It can be hard to even begin to explain to most people what my life has been like lately.

Life outside.  Where the language is different, the breeze is fresh, the stars are in the sky, the people are healthy.  What do people talk about all day on the outside, away from the planet of the ICU?  What can we talk about if we're not talking about illness, vent settings, lab values, chest x-rays, antibiotics?

But life outside goes on.  My husband and daughter have the unique ability to almost immediately draw me back to a much different, but no less true, reality.  And I'm so grateful.  I've been straddling two worlds and I have a purpose in both.  The juxtapositions of life and death this month have made for some interesting food for thought and fodder for prayer.

My Husband, the Hobo

Last Friday evening, I was still at the hospital when I got a text message from Aaron telling me that he'd made a big mistake.

Without any further details.

I'm already on high alert this month working in the ICU, so I was pretty worried. As far as I was concerned, sending a text saying he'd made a big mistake without explaining was, itself, a big mistake. I tried calling him a few times, but he didn't answer. Finally, I got a hold of him.

As it turns out, on the way home from picking up Julia, he had hit a curb and blown a tire. Then, he swapped the tire for a spare, but had left the hazard lights on during the tire changing, draining the battery (which, as it turns out, needed to be replaced). The car wouldn't start, so he got the stroller out of the car, put Julia in it, and started to walk home. A two and a half mile journey. In the dark. On the sloped, grassy side of a major street, part of which didn't have a sidewalk. Wearing his white coat and dress clothes from work.

!

One of the residents I'm working with this month was nice enough to let me leave work to go pick Aaron and Julia up when I explained the situation to him.

I'd almost reached Aaron, when I got a call from him, saying he'd gotten a ride. My parents and Sarah had happened to drive past on their way to Elizabeth's chorale concert (he hadn't called them previously because he thought they'd already left home), saw him, and picked him. Apparently, when they first saw him, they thought, "Who's that crazy man wearing a white coat pushing a stroller in the dark?" My sister figured he was homeless. And then they realized it was Aaron.

Yep.

That's a mental image they're not going to forget for a long, long time.

Eleven months! Craziness!

Julia turned 11 months on Saturday! Craziness! Less than a month now until her first birthday! Where has this past year gone?!

• Julia is talking more and more! She's getting really good at saying words in their proper context! She is also able to repeat words pretty well, usually at least getting the first syllable right. Some new words this month: "mama" (with the correct association! ;-), "nana" for banana, "moo" when asked what sound a cow makes, "bop" for boppy, "wa" for water, "ma" for monkey, "Julia," "no" and "yeah." A couple weeks ago, I told her no about something, and she said, "ye!" I repeated no, and she repeated "ye!" Isn't it too soon for her to already be arguing with me? ;-) My mom has also heard her say "Sarah." And tonight, I pointed up at the crucifix in her bathroom and, clear as day, she said, "Jesus!" Yay!
• Julia has gotten great a climbing. She loves climbing on the fireplace and under tables, and she has so much fun climbing the stairs at my parents' house. My mom puts the pack and play in front of the stairs to keep her from climbing, but she recently figured out how to shove the pack and play to gain access to the stairs! Sneaky baby!
• She is getting a couple more teeth up top - bringing the total to 6.
• Julia is a good eater! We reintroduced wheat without incident. She's been eating a wide variety of foods and really enjoying them. She had ice cream - Dippin' Dots - for the first time at the mall when her Grandma Mary was visiting. She hasn't had any ice cream since, but if she's truly our daughter, we're pretty confident it will be a favorite :-)
• Julia is getting good at playing ball. We roll it to her and she rolls it back.
• She's really great at letting us know what she wants via noise and gesture
• She is sooooo close to walking. She's very steady standing and walks with support so easily. But, every time she's attempted that first unassisted step, she's fallen. Not much longer, though! We finally broke down and bought her some shoes so she can romp around outside without hurting her feet.
• Julia is giving hugs now! So sweet! She spreads her arms wide, puts her head on your shoulder, and squeezes. Love! She also gives stuffed animals hugs now, which is so cute!
• Julia Grace is our pride and joy! We love her!

Outtakes, for your viewing pleasure:

Being in my crib makes me SO SAD! Don't even TRY to get me to smile!

I am NOT staying in this baby chair!

Code Blue

Twelve long hours
Time for leaving
To see my family
Code Blue

Walking quickly
White coat off
Yellow gown on
Heart in my throat

Chest compressions
Starting too quickly
Feeling overdosed
On adrenaline

Must slow down
Focus hard on
Staying alive
Staying alive

Arms get tired
Rotate students
Nervous hoping
Still no pulse

Chest compressions
Hyperventilating
Tingling arms
Staring at death

Wife is crying
Forty minutes
Still no pulse
It is finished

Clean up body
Remove tubing
Tears that welled
Leak out

If perceived as weak
I don't care
I am human
Tears belong

Hugs from classmates
Good team effort
Finally time
To go home

Hot, hot shower
Wash the code off
Praying hard
Trying to calm

Mind won't let me
Arms won't let me
Nerves won't let me
Shaking still

Hugs from husband
Prayers together
What would I do
Without You, God?

Tomorrow may
Be just as hard
Medicine
Is heavy

Oh sweet Jesus
Please give me strength
To face death
And live my life