I see you...

I just started my Intensive Care Unit (ICU) rotation and it's been quite the adjustment, getting to the hospital at 6am. My last rotation was infectious disease and it was a great experience because the attending is brilliant and loves to teach. In addition to that, he usually started rounds around noon, so we usually started our day around 10am...man, that was nice...

ICU is interesting because you have patients that have nearly everything wrong with them and need it all managed. There is a lot of opportunity to learn and solidify concepts you've been exposed to in med school.

As we were doing rounds, walking from bed to bed and discussing the patients with the resident and interns, another med student pointed out to me that it was almost like we were at a zoo, the patients in their rooms with their exotic illnesses, as we walked by, gawking and remarking on how amazingly bad someone's ABG was or how severe someone's urosepsis had gotten...

It made me realize that in our earnestness to learn, you can't forget these are people grappling with very serious illnesses. I think part of the reason it is easy to forget is that more than one person in the unit has diminished mental status, so it's easier to think of them as just some "problem list" that you need to work on "solving". And yet these people are the ones who are most in need of our extra efforts and compassion. Their illnesses have overwhelmed them to the extent that they have lost awareness of themselves; and yet their eyes remain open, with vacant stares that chill you...

Many people that see such scenes, whether it is physicians, nurses or the patient's family, often say they would never want to end up in such a state, that life is not worth living under such conditions.

I'm not sure where I stand on the issue.

I do think we should do our utmost to preserve and extend life. I'm not sure what role quality of life has in that equation, that is, at what point can quality of life override the imperative to preserve life? If we say that quality of life can override efforts to preserve life, then where do you draw that line? Doesn't that open up a slipperly slope?

Too much for me to delve into right now...gotta get up at 4:30 so I can get to work by 6...