Estoy esperando trauma.

As May moved into June I transitioned back to the Trauma ICU. Unlike the last time I was here they have put me back on nights along with Rachelle. Both she and I moved from Vascular to TICU nights together.  So I've been burning the night oil all week long, but on the flip side 1:00 in the afternoon you'll find me curled up under my covers. It's trauma season; meaning, you wait for those level 1 traumas to come in each night. We've only filled up our beds one night of the six so far, although tonight is quickly heading in that direction as well.

There was a death in the TICU earlier today. An old individual with a broken neck. Lungs were no longer working.  Nor the kidneys. Brain stem reflexes... absent.  But we kept the breathing machine going as we waited for family to arrive.  We waited for over a week. And every night the daughter would call and have the same conversation with us.  Are they talking? No.  Can we take the tube out of the throat? No. They're getting better, right? No.
The daughter did finally come.  She came today.  She walked into the room and started talking to her parent. Within 10 minutes there was no more heartbeat. She had come for withdrawal of care, but no withdrawal was required. It was almost as if that patient had waited for the daughter.  Who knows, maybe they had.

Pain. It's all in the head.  Really.  That's not saying you do or don't hurt.  It's saying that you can have the exact same level of pain with a broken rib as without a broken rib, if the pain receptors in your brain are firing.  It is probably the single most area of medicine in which I struggle with empathy.  However... I'm not alone in that. This is the trauma ICU. Pain is status quo. And then you have grandma over in bed A with every single rib fractured on the left side.  Well, she's chillin' like a villain on nothing more than tylenol, doing her lung exercises like a champ! And we get an admit this evening, adult male with a couple of cracked ribs. There's five of us in his room to get him situated. Time to turn him and he throws a fit. It becomes quiet except for his complaints, and I can see in the eyes of each of my colleagues either emptyness (they've stopped caring, no longer listening to his excessive complaining) or numbers (1... 2... 3... as they make their way to 10 in an effort to prevent themselves from yelling at the patient).

Different individuals handle pain in different ways.  Or in other words, some do handle whereas others don't.  I will give you a helpful hint: The first step to handling your pain is to work with your caregivers. You show them you are on board with getting yourself better and they will gladly order the pain meds you need.

Much Love.