Hola a tod@s, my dear Friends.
From the intensive care bed…we need to hear and listen, just published in Intensive Care Medicine, the journal of European Society of Intensive Care Medicine. (ESICM).

It is wonderful that the most important impact devoted its space and time to help generate awareness and knowledge. Something is changing!.

Darryl, a 46 year old businessman, crashed his motor-cicly against a truck. He arrived at the Hospital in hemorrhagic shock and after an abdominal ultrasound, went to emergency surgery. Multiple injuries were found: a tear in the heart (the right atrial appendage), retroperitoneal damage, an open book pelvic fracture, a liver contusion, multiple rib fractures, hemothorax and severe pulmonary contusion. He APACHE II Score was 36. And his admission to ICU lasted 35 days.

This is his story from the bed…

“My first memory of the ICU was hearing a doctor saying: ‘Wellcome’. I had been in a induced come almost 3 weeks. Doctors told my wife the first day that I had less than a 1% chance of surviving. It was a miracle.

I fought for my life 5 weeks, 2 of them I was conscious but very stunned. At that time, I endured and suffered different hard challenges as an ICU patient.

The daily ritual of the consultant swinging by with his entourage was an experience. At the end of my bed he said: “Mr O’ Callaghan is a MBA”, before talking about my injuries and my treatment. The same process everyday, and I always wondered: why always called me MBA (Master of business administration)?. Perhaps do I have preference due to my resume ? That should be the explanation, because if not, I did not understand it. Thanks Good that I had made that master.  Only later I realized that MBA was the term used for MotorBike Accident!.

That was one of the many situations of confusion that I experienced in the ICU. They talked about me but without me. I was intubated and I couldn’t speak, but I could see and hear. It was very dangerous to leave me to create my own interpretation of the facts. In my opinion, communication skills are essential in the care of patients. Convey tranquility with words of comfort, explain the condition and treatment plan.

There was water everywhere, but I couldn´t drink a drop. It was my only thought. I had fever for several days, and they did not give me water. And I saw the nurses writing their part beside me with a bottle of crystal water… A psychological torture!. First message: drinking water in front of an intubated patient is equivalent to torture him.

Time. Long time.

My body broken into a thousand pieces and I could only look and listen. There was a clock in my box, and I confirm you that one minute is much longer than 60 seconds when the only thing you can do is to look at the clock. Every second seems an hour, every hour a day. Consider removing those damned clocks!.

I expected to be admitted in an easy place to rest, but the high fever did not allow me and I had nightmares. And in addition, the ICU never sleeps: 24 hours working. The lights are always on, people on the move. We all know the effect of deprivation of sleep in a healthy person, so that was another torture. Please: find a way to get a normal and restful sleep in the ICU.

And the discharge to ward, another nightmare. I thought it was the best day of my life, but in 10 minutes I went from having a nurse 24 hours a day and connected to something as well as the Enterprise  thanks to the monitoring equipment, the solitude of a room and a small sensor of pulse in the finger. I was frightened, isolated and anxious to know if ward nurses could assist me quickly if something went wrong. I still wasn´t recovered, but the level of care passed entirely to almost nothing. An easier transition would have done wonders in my mental health. Perhaps an ICU nurse could visit the patient with long ICU stay every two hours as a solution for the first 24 to 48 hours.

The ICU saved my life and I will always be indebted to the staff who took care of me. Thanks to them I live a second chance. My heart hope is that by sharing this story, that grueling trip that I went through as a patient, ICU team reconsider the form which treats patients in order to reduce, if not eliminate, the burden of fear, discomfort and errors of interpretation that continuously patients live.

‘‘Time is not the great teacher. Experience is. A man may live a whole life, but if he never leaves his home to experience that life, he dies knowing nothing. A mere child who has suffered and lived can be the wiser of the two.’’


From IC-HU Project, congratulations to Darryl O’Callaghan in this second chance and thanks for telling his story, and our mates Anthony Holley and Jeffrey Lipman, From Department of Intensive Care Medicine in The Royal Brisbane and Women’s Hospital, Australia.

Happy Saturday.