An 18-year-old was admitted to our ICU with a questionable diagnosis. The drug screen did not reveal what he had taken. Our ICU intensivist speculated he ingested bath salts. Bath salts came to the U.S. around the 2010s. It was cheap and, even better, considered a “legal high” as it was not detectable in drug tests. Josh came to the emergency room psychotic, paranoid, and hallucinating, with hypertension and SVT. …
This story has been fictionalized.
Dorothy Klein. MRN 508291987. DOB 12/22/1962. Patient A-. Unit A-. Unit number W038306745014-K.
OK. Next.
Dorothy Klein. MRN 508291987. DOB 12/22/1962. Patient A-. Unit A-. Unit number W038306928906-K.
We finish checking the emergency release blood and wait. We know that whatever was coming up isn’t going to be pretty. A lung transplant gone bad, uncontrolled hemorrhaging, 14 hours on the table. So much blood transfused, an exploratory laparotomy was …
For a while, I enjoyed telling Dave’s story. In the beginning, I found it therapeutic. It was just as unbelievable to me as it was to the person I was telling it to. Somewhere along the line, telling the story of Dave’s accident and the health care nightmare that followed became more matter of fact. Then, it became heavy.
What I didn’t tell most is that Dave’s injury took more than …
Room 1, ICU — Love on life support
This was a busy Saturday in 2022.
06:45 — I walk into the unit and spot a gray-haired man pacing outside Room 1. Clothes rumpled, air sharp with sweat. The moment he catches my white coat he stops.
“Doctor, any updates for me?”
Through the glass I glimpse his world: a woman in her …
We were a team. Always had been. Always would be. We defended each other, protected each other—from management, from nurse bullies, from the cruel ICU doctors who thought they ruled the world. Back in the day, we had our own kind of “therapy sessions”—long talks over coffee, unloading the weight of twelve-hour shifts, of lives saved and lost, of the battles fought in the trenches of critical care. But life …
It is more than our job,
Our profession,
Our specialty.
It is our life,
Our calling,
Our vocation—
A privilege.
Taking care of the sickest of the sickest children,
The most hurt,
The most wounded,
The most injured,
The most vulnerable among us,
The most precious of human …
The most difficult transport I have ever encountered was during my pediatric critical care fellowship. I traveled to an outside hospital with a fully equipped pediatric critical care transport team, including a critical care nurse, respiratory therapist, and myself—a third-year pediatric critical care fellow—to pick up a toddler ejected from a vehicle during a high-speed collision. Upon arrival, we found a child who had undergone an open laparotomy, open clamshell …
An excerpt from Yankee Doctor in the Bible Belt: A Memoir.
We work in high-pressure environments, where Dr. Death is often lurking. We can be superstitious. We can protect ourselves with a sense of humor. We can use words as a smokescreen to protect our sanity. See below.
I was a resident working in the NICU. The shifts were long—sometimes as long as thirty hours in …
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We sit down with pulmonary and critical care physicians Tonya Jagneaux and Hollis O’Neal to explore the complex challenges emergency departments face when diagnosing and treating sepsis. With overcrowded EDs, rising patient volumes, …
During my time as a medical student shadowing in the intensive care unit, I met Ms. Stacey, hospitalized with a severe intestinal infection. As I entered her room, I saw her frail form lying amidst a web of tubes and monitors. Her prolonged hospital stay had visibly drained her, leaving her dependent on the vigilant care of both the medical staff and a quiet, devoted man sitting beside her bed—her …
My first ICU rotation of intern year was filled with great darkness. It was dark outside as I walked from my car into the hospital each morning before sunrise, and it was again dark when I walked to my car at the end of the day. Less than one hour into my first day in the ICU, a patient’s weak and ineffectual heart stopped beating, and CPR was swiftly initiated. …
In the ICU, there was an experienced nurse. She was full of information and knew the policies and procedures inside and out. She was proficient in her role as an ICU nurse.
But she was flawed. Something was wrong.
Each day, she came to work wearing a gold bracelet, which she made sure everyone knew was valued at $15,000. She wore two-carat diamond rings. She would arrive, showing off her fancy pocketbook …
A physician in the pediatric intensive care unit (PICU) requires vast medical knowledge along with emotional resilience. I always thought I had a strong sense of compassion for my patients and their families until I had my own baby 1.5 years ago. It completely shifted my perspective. I started to understand parental grief and fear on a personal level, which reshaped my approach to work.
Before having a baby, I was …
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Recently, I had the privilege of being shadowed by a medical student who is interested in becoming a pediatric critical care medicine physician like I am. On the day she came to observe me, we were navigating a busy and heartbreaking time in the pediatric intensive care unit (PICU). I was curious how the experience would affect her and her decision, but I figured it was as good of a …
This piece is inspired by my recent patient encounter. Within the past week, I received a call from the ER to admit a 29-year-old African-American female whom, for the sake of this essay, I will call Keisha. Keisha presented with severe lower abdominal pain and was found to be in hypertensive crisis. Her systolic blood pressure consistently was in the upper 200s. It turned out that the young lady suffered …
Springtime. Blooming trees. Green grass. Cool winds. Sunny skies. COVID.
That is where my mind wanders every year since 2020, when the season turns. I flash back to the drive between the hospital and my home. Every evening after fighting a losing battle at an academic institution hell-bent on ignoring and downplaying the horror that was about to breach our borders. I was a fighter then — maybe more in that …
As I stepped into the hospital waiting room, the anxious eyes of family members greeted me, their worry palpable as they awaited news about their ailing patriarch. Quickly, I introduced myself and delved into the heart of the matter.
“I wanted to talk to you about your father’s condition. It’s not easy news, but I need to be honest with you. Despite our efforts, your father’s brain suffered irreparable damage during …
I’ve created cartoons using DALL-E, each with its own humorous caption. They’re all original ideas from me, but I used the AI to visualize them. Although they mostly touch on topics related to pulmonary and ICU medicine, I think they could catch the interest of a wide medical audience. Given the pulmonary theme, I decided to call the series Take a Breath.
“I could have saved him,” the intensivist murmured, reflecting on a recent patient’s death. His silhouette was framed against the fading evening light that spilled into the ICU. His words, heavy with regret and resignation, floated over the hum of life-sustaining machines, recounting the tale of Caleb Stratford.
When Caleb Stratford (not real name), 61, was rushed to the hospital last June, the shock trauma team at the University of Maryland …
A small, cliquish bevy of nurses was working their way through orientation in the NICU straight out of nursing school. They were happy and thrilled to be accepted into this specialized nursing unit: the NICU.
Practicing good hygiene, washing hands up to the elbows with soap each time one entered a baby’s cubicle, and gowning and gloving was a standard and mandatory protocol before touching the babies.
These were preemies in the …
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