im电竞官网-The hardest thing I ever did as an intensive care doctor was knocking on a door. In 2018 I visited the family of a patient I had cared for a decade earlier. Chris died just days after blowing out the candles on his 18th birthday cake. He’d had sepsis, and had spent over six weeks in intensive care.
im电竞官网-He was the reason I chose to work in the Intensive Care Unit (ICU). Healthcare workers often talk about those they 'carry': patients or families that stay with us over the course of a career. Chris has stayed with me.
COVID has brought new memories for us all to carry. In a decade’s time, I’ll remember not only knocking on that door but also pressing the rubber keys on a phone. I chose intensive care as a medical speciality because I wanted to think as well as to act. Now I realise that above all I just want to communicate, with patients, with families and with colleagues. Communication is healthcare’s most valuable and yet most dangerous procedure, verbal dexterity mattering much more than manual. Yet COVID has stolen face-to-face communication with families when they need it the most. Instead, we break bad news through the twisted cord of a telephone where the power of silence can be mistaken for a hang-up.
We move heaven and earth to let families spend time with loved ones who are dying. Yet sometimes the earth is too heavy, the time too short. And so we press those rubber buttons on the phone.
I know from personal experience that even the sound of your own ringtone on a television program can induce panic when hanging on for news of a loved one who is unwell. “What if it’s the hospital?” So now I try to start my phone calls to families with, “Don’t worry, this isn’t a bad news call”.
Not this time. That would be a lie. It is bad news. The worst. I begin: “So sorry to do this over the phone…” The call ends with quiet sobbing. We promise to hold the patient’s hand. To play his or her favourite song. To tell them that their family loves them. Loved them. Because, soon after, they die. These are now the people I will carry with me. So, too, the nurses, the physiotherapists, the receptionists who file the death certificates, the cleaners who clean the empty beds. We all carry COVID, not on our skin but in our heads and in our hearts.
And we also carry the good news. The big save. The family reunited. The against-all-the-odds recovery. Because some will survive. And we are also very lucky. Healthcare workers get some certainty in this time of change. We get paid, we get food, we get clapped and we clap back. So many others in society must pray for such things, as the food banks are harvested and the bank accounts turn crimson.
How does it feel to work in intensive care during a deadly global viral pandemic? Unsurprisingly, the number of appropriate analogies is small. In the early days, back in March, it felt a bit like being a first time parent, living in a one bedroom flat, when your baby comes a month early, and that baby is one of triplets. You start parenthood feeling knackered after weeks of sleepless nights. Your good intentions to paint the nursery and have your bags packed ready slip by. You worry about your ability to care for more children that your hands can even carry. You also worry how you are going to get through this unscathed. Even if you have enough cots and nappies, the physical infrastructure of your flat is not fit for purpose.
im电竞官网-Yet you do get through it. Adrenaline, love and hope are your fuel. The early days are hard, the later days even harder. But your children do survive. You change your flat to better care for them, you get systems in place, you find others you can rely on. You cry but you also laugh out loud. Will you come through unscathed? No. But most of the scars are ones that will heal and remind you of what you have achieved. Life will never be the same again. Some parts worse, many parts eventually better. But it is after the novel has settled down and people stop offering help, that the really tough times begin.
im电竞官网-That is why I am asking for your help. My hospital is unusual. We have a skilled clinical psychologist who is there for the staff as well as for the patients. We have a wellbeing programme threaded through the organisation that tells us that it is OK to not be OK. We have been given permission to worry, to talk, to breathe out as well as in. That gives us the permission to also bounce back, to stay well and continue to be able to protect, to watch over the next patient with COVID or cancer or heart disease. But this support is not typical. It is not the case in every hospital. Many healthcare workers may struggle to cope.
im电竞官网-The many small gestures are incredibly important. The rainbows painted by children I see on the walls as I leave the ICU turn COVID grey into a hopeful green. The clapping I hear through my car window as I drive into yet another night shift drowns out the sound of another news report. The public have been amazing in their support. We thank you all.
But if you want to do more — and I hope that you can — then please support the for all of the workers in the ICUs across the UK.
Perhaps think about donating the cost of that coffee you can’t buy, or that night out you missed, to our campaign to support the whole of the ICU. I want everywhere to have the support we have at my hospital, and the permission to not be OK.
Thank you for your support, we are here for you. We are here to carry you when you most need it.
Dr. Matt Morgan is a Consultant in Intensive Care Medicine at the University Hospital of Wales, and an Honorary Senior Research Fellow at Cardiff University. His book “Critical: Stories From the Front Line of Intensive Care Medicine” is out now in paperback. He lives in Cardiff with his family.
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