What I learned from the ICU (other than medicine)!

This week I had some particularly emotionally tough cases at work and it got me thinking about life in general and how, in spite of having a tough job, I have learned so much from it. So many life lessons have come from working in a pediatric intensive care unit and I have extrapolated many of those to my everyday life. So, this week, I wanted to switch it up, move from health (check out our last post here), and write a life post about life lessons from the ICU.

Acute versus Chronic

Don’t get me wrong, all illnesses in children are sad. However, I think of there being two main types of conditions. There are the ones that are chronic, the ones that let you process that your baby is sick and has a potential life threatening condition. You have weeks and months to absorb it. Then there are the ones that all of a sudden, in the blink of an eye, without warning, take the child you once knew away. Forever. When I say take, I don’t mean death, although sudden death is certainly another way this can happen.

I am talking about the child who is alive and well, perfectly normal, bright, smiling one second and the next something happens that will never let you see that child in the same way again. These are very often devastating brain injuries. This week I had two such cases.

Families will often bring pictures of their pre-devastation child to decorate the walls of the room. So you walk in and you see how that child was and you know his/her present. You see the laughter, the family celebrations, and the special moments, all around their bed. 

Meanwhile, the families are trying to process what happened. Holding on to the hope that their baby will come back. You, unfortunately, have seen enough to know these children never come back to be exactly how they were before. You stay quiet, go through the motions, try everything you can to see if, maybe, this one will be different. After all, who the hell am I to destroy their hope? Do I know everything? Hardly.

As the days go by, we slowly guide them towards acceptance that this is their new child. That the smiling boy or girl they remember is gone. It’s heart wrenching. It  drains you. It’s the stuff my worst nightmares are made of: What if it happened to my baby? Certainly, one of the many reasons there is such a high burn out rate amongst physicians in the intensive care units.

Five life lessons from the ICU

Writing has become an outlet for me, a way to disconnect and discuss unrelated health and life issues. As I sat down to think about this past week, I couldn’t help but think about how medicine and, more specifically, the ICU have shaped me. So many lessons learned, so many applied to my everyday life. I thought it would be helpful to share a few.

Don’t take anything for granted and enjoy every second

Every second that you have with your child, your parent, your family and your friends is a GIFT. Acknowledge this and savor every second. Inhale your baby’s smell as often as possible, tell your friend how much you love them, don’t be afraid to take a leap and try something new. So many people don’t have that or get cut short from spending time with their loved ones. Life goes by in the blink of an eye and sometimes it goes unexpectedly, so make sure you enjoy every second. You never know if it could be your last.

Get your priorities straight, figure out what matters and cut the bulls#@%

This really annoys me. I see so many fights and arguments going on between family members when their children are sick. Sometimes it’s the mother and father, sometimes it is grandparents, and other times siblings. You name it. At times, these surface at the time of the child’s illness, but other times these are fights that have been going on for years. Ninety percent of the time it is over trivial things: somebody said something that hurt me once and I cut them off, x family member took family money and now they are fighting over it, the in-laws don’t get along with each-other/a spouse, etc.

When I look at the big picture and the time I have here on this earth, I think: Am I really going to spend the time fighting over money or my perception of something that I considered offensive or disrespectful? Or will I try to make the most of it, talk about things and put our differences behind us so that we can enjoy the time we have together?

Some relationships don’t work out, for example, your current spouse may not be your forever partner. However, how important is it that you keep hating him/her and try to make his/her life impossible? So many times we keep hurting each other, purposefully. Nothing good comes of that. When you are at your deathbed, will you be thinking how great it was that you spent a lifetime torturing the person you disliked? I think NOT. So, LET IT GO. Get over it. If you don’t like that person, then don’t hang out with them. Be cordial and move on.

Let’s get some perspective with some real life things I’ve seen in the ICU and the end result of these:

Don’t like your adult son/daughter’s spouse? You’ll miss out on your grandchildren. Have a strained relationship with your child? They will leave the first minute they can. Fighting over inheritance money? You may have nothing left by the time you are done with all the legal bills.

It’s just not worth it. Sooner or later you will regret it. 😞

Skin thickness: thicker is better

In order to accomplish the previous point, you have to be able to NOT take things personally. Don’t get offended so easily.

By virtue of working in the ICU, I have been fortunate to have AMPLE opportunity to develop thick skin across the years. I work with plenty of surgeons, who historically, have difficult personalities and not a lot of filter, so that has helped develop this skill.

In addition, families have different coping mechanisms when their children are sick. Some are extremely sweet and grateful, others fight you on every decision, others go through denial and still others decide to blame you for their child’s illness.

This last one is the hardest. Anger is their coping mechanism. They will take that anger out on anyone who is close by. In my time as an ICU physician, I have received more than my share of insults. Toughest one? 

One mother questioned my fitness as a mother and stated that my child must “hate me” because I was such a horrible person. 😱😱 I will admit that one stung. However, her adolescent son was dying from cancer. There was nothing anyone could do. Nobody could help her. If I took it personally, it would change the situation and make it about me. Nothing in that room was about me. It was about her and her family. So, I said I was sorry she felt that way and walked out of the room. I walked in a few hours later to report time of death.

The ICU isn’t for the thin skinned and honestly, neither is life. Take things in stride, don’t make it about you and don’t take it personally.

Keep calm

Life is going to throw at us all sorts of situations. In the ICU, things can change from one second to next. One minute everything is fine and the next you are called to an emergency. You can’t walk into the emergency screaming. You have to be calm. Your mind needs to be clear. Even if everything is falling apart, YOU have to keep your cool. Your team is counting on you.

We need the same thing in life. Admittedly, I have been more successful in keeping my calm at the bedside than in everyday life! 😂 However, that is what I strive for. Whenever a crisis comes in to my real life, my first thoughts are: “Deep breath, relax and don’t freak out”. It is super important to take a step back and survey the situation, so that you can take appropriate, rational action.

Pick your battles

In medicine, just like real life, some things are absolutely necessary and some are negotiable. Some parents may refuse a particular treatment. Some of these are key to the child’s well-being and some of these aren’t. When dealing with a family refusing treatment (for whatever reason), I only push for those that are absolutely needed for the child’s health and/or we don’t have an alternative treatment for.

This is the same modus operandi I apply to real life. How important is something to me? Is it worth going head on with someone? If the answer is that it isn’t so important, and I just want to go into it for the sake of being right, I let that fight go. I don’t engage. It’s better to save that energy for the ones that I truly care about. Otherwise, you drain your energy and wont have any left when you really need it.

And in the end, remember

Young, old, rich, poor, and across all races: we can all get sick. We are all vulnerable. We are all on this earth for a brief period and the end point is the same.

Don’t let anyone intimidate you, don’t let anyone belittle you. Particularly important for us women when working in male dominated fields. Nobody is above you, nobody is better. We have the same basic components: skin, bones and internal organs. So, go ahead, dream and then go after those dreams and make them happen. 💫

Have a great week team! I have one more week of crazy hustling before I can take a breather. 😓 See you next week!! ❤