Most of us have been in the ICU of hospitals at some time or the other. An intensive care unit (ICU), also known as a critical care unit (CCU), intensive therapy unit or intensive treatment unit (ITU) is a special department of a hospital or health care facility that provides intensive care medicine. These Units cater to patients who suffer from life threatening illnesses and/or injuries and when the condition warrants close monitoring and support from specialist equipment and medication in order to improve the patient’s condition. The ICU is supposedly manned by highly trained doctors and critical care nurses who have been trained in caring for seriously ill patients.
If you are admitted in a comatose or even semi comatose condition, it really does not matter what happens around you. But when you are not all that ill, have your mental faculties intact, and have had the misfortune to be kept in the ICU, just “for observation” for the night or the next day as I was on two occasions, the miseries are manifold.
Firstly, you are moved from the emergency to the ICU and instructions go back and forth between the ward boys and the nurses over your head and you sigh in relief as you are wheeled into a refrigerator. Ah yes, you have to wear the hospital gown. Gone are the comforts of thick cotton gowns with tapes at the back. The ones you are given are paper thin, translucent, and you guessed it, eco friendly and disposable without the headaches of laundering. They are fastened with Velcro at the back, which hurt as you lie flat, and with maneuvering and twisting like I do, the fastening comes off. Fortunately or unfortunately you are surrounded by co-patients who don’t have the energy to ogle, or see you in a half clothed state. Uniformity persists and at times difficult to tell a male from a female, so you are cloaked in anonymity. It is easy to contact pneumonia in these surroundings!
Lowered on to a waiting bed, the monitors and tubes are all in place as your progresess is recorded and your fate described electronically. There is a file on you, and interns and young doctors enquire politely how you are, and ask what exactly is the problem. The problems? “Innumerable”, I want to say, as I clench my teeth in an effort to keep them from chattering. “It is i..i.cyc..c..cold”, I venture. My toes generally go into a cramp if they are chilled, and dash it I forgot to bring those warm woolen socks knitted for me by Sue, my sister-in-law, who believes that woolen socks should be part of ones wardrobe and her insight is to be lauded. They bring you blankets, cotton blankets, one at first. When I still chatter, they place another one on me. “She must have fever,” say the nurses and check my temperature which is absolutely normal.
Since I was conscious and mobile I did not want a bedpan. I was however assisted by a kindly nurse, and I felt a rush of cold air behind, and realized the back was fully open. Giving up futile attempts to cover my behind, I shuffle to the loo which has bedpans, urine bottles, beakers and other stuff.I asked if I could read, and in a moment of weakness the sister gives me the newspaper which I could not enjoy, as the light was dull and the headlines screamed murder most foul, theft, and other heinous crimes including rape. Enough to depress even the most cheerful person around.
When the Chief comes on his rounds, there is a bustle of activity as files are updated and every comment of the Doctor is recorded and hopefully carried out. Your fate (read stay in the ICU)rests with the good doctor.
End of the day but the ICU is forever night with artificial lights, and you lose sense of time though aware that it moves ever so slowly. You welcome the night, as the end of it you will see the day, and that means discharge or at least a move to a ward where you see life around you. But you are not prepared for the night and the surprises it brings.
The handing over begins as the shift changes. The nurse-in-charge loudly tells her takeover counterpart every single detail of the patient, his or her physical condition, through the well worn file. By now you know your entire history by heart. Lights are dimmed and you are gently asked to sleep.
That’s when the fun and games begins. I thought ICUs would be silent zones where soft footed medical staff would be Florence Nightingales .Not so in your wildest imagination. Cries of “Narayana, kadavale!” rent the air, as one male patient believes he is being assaulted. “Thatha, don’t shout”, says the young nurse as she runs to placate him. Two beds away another man who has been relieved of his tubes sleeps but lets out the strangest of noises and loud snores oh so familiar. It makes me terribly homesick.
The interns and nurses discuss their day with gusto. They talk about in-laws, out-laws, the state of economy in the country, the corruption, politics and various other subjects… and the emphasis with which the discussion goes, pales drawing room conversation into insignificance. They joke and laugh loudly and in my disturbed dream, I imagine glasses clinking and people laughing in a half drunken state. I sit up in bed, call a nurse to my bedside who “Ennama”s me, and I tell her in no uncertain terms what discourtesy it is to such sick patients, and that I would write about the attitudes here and complain. Very deflated the matter is reported to the doctor, and silence persists for sometime before the cacophony begins again.
The next day I am cheerfully told I could “go” and I feel that I have been released from jail.Though moving to the ward is another process which you suffer there is the promise of your own gown, and the warmth of family attenders and then home. The ICU is the loneliest place in hospital hell, where you lie removed from family and contend with tortuous thoughts. Recovery when you are not so seriously ill, is faster in your own home, with nursing staff and the comfort of familiarity. Ah for midway nursing homes where you could just lie back and allow yourself the luxury of relaxing, without the endless disturbance of hospital routine!