It was a summer morning. Those where the heat and humidity of the Mediterranean fall you by your back the first thing in the morning.

I had an appoinment with him. Antonio, an anaesthetist and ventilation expert but without the prestige of others, although dozens of residents have learned of his mastery. We knew each other and I was impressed by his humility. In addition, to go to that great university hospital to explain a  new ventilatory full service mode supposed a huge challenge for me.

We installed the new ventilatory software, advanced – the word that comercial enterprises use – synchronous, perfect… Pure amplification of the respiratory cycle of the patient adjusting to pulmonary changes of compliance and resistance. Measurements every 200 milliseconds… Waaaoh!… Software and pure engineering in form of algorithm of the air movement in the lungs. 



 
John was lying in his bed. Asleep. Tube in the mouth, when we started the theoretical session service. Just 20 minutes. Despite the complexity, everybody understood this in the Power Point that we present. Then we went to his box and he woke up quickly. I introduced myself and we explain what we were going to do. He seemed resigned after several weeks of failing in the removal of the respirator.

A quick review of the status of the patient, manual settings, and “Click”. We activate the software and with it my explanations of what was happening: “A variable respiratory pattern cycle to cycle, a little higher frequencies than in pressure support, slightly lower volumes, but the volume min sustained, full disappearance of double and triple cycles, ineffective and any type of asynchronous respiratory efforts.”

So many times before I usually had commented: “The patient tends to be so comfortable that even cases of addiction have been described”. John had not lost any of my explanations and when I asked him how he was, he rised rapidly the thumb.

Everything was going fine, the perfect performance: we control the situation with the patient happy. After 30 minutes we faced the end. “What we do now?” I asked. Antonio the anesthesiologist said to me: “Let´s go back to support pressure -” taking the most conservative decision. And that we did it.

In just one minute, we were still in the box washing our hands, Juan hit the bars of the bed protection with angry. His rabid eyes watched me furious. His trembling hand pointed at the ventilator screen and he shrugged his shoulders. His expression told me “What the hell are you doing?!”. With the knuckle of the finger he hit the screen pointing out something that there was inside… He was asking me something.

I quickly asked: “Do you want back you were a while ago, right?”. He nodded his head. I looked at Antonio who also nodded. And that happened… I left the hospital knowing that John was breathing in that perfect and harmonious way that emanated from a sea of complex algorithms and microchips that would let him comfortable.

Another proof that technology humanizes the attention if you know how.
 @carlescalaf

A story based on real events.