A Happier Post

'Bout two weeks into my ICU rotation and it has been a wild ride for me so far. I thought I'd post a little about something positive, since the tone of the last post was overwhelmingly gloomy.

I mentioned the young guy who rolled his car and ended up as an organ donor in the last post. One of the surreal things about a surgical ICU is that the patients that got that kid's organs are also now patients of ours in the ICU. I'm personally assigned to the guy who got his heart. This guy was born with a heart defect that often prevents people from getting very old or very big. He's an unusual case for this particular type of heart problem because he's in his 40s and he's a large man. That's made it tough for him to get a heart because he needs a heart from a big donor--like the kid I mentioned in the last post.

He has been on the transplant list for about 3 years. Because a heart transplant is such a big surgery, it's not uncommon for patients to be sedated for a few days after the surgery, and this guy has been. He's also intubated, so even if he was awake, he wouldn't be able to talk to me. So until yesterday when I got the chance to talk to his sisters for a few minutes, I really didn't know much about him except what I was able to read in his chart, which is mostly dry medical jargon. You don't get a lot of the social history that puts all of the medical information into a human context, unless you're able to talk with your patients or their families. His sisters told me that he'd been going down hill physically for the several years, but only within the last few months had he become discouraged and psychologically defeated. For most of his life, and particularly in the last 3 years when it became apparent that he would need a transplant, he had had an overwhelmingly positive attitude about his condition. They told me how worried they've been for him lately because he was getting so discouraged and was losing his will to keep fighting.

It was quite a contrast to talk to this man's family about the excitement and relief that they felt when they finally--after 3 years of hoping and waiting--got word that he was going to get a new heart. It's a surreal experience to see one family wracked with grief over the tragic loss of their son, brother, husband and then two days later see the beneficiaries of this tragic accident and the joy those families experience (we've also been taking care of the two patients who got this kid's kidneys; they are both younger than 20 and doing very well with their new kidneys).

This guy is certainly not out of the woods yet, but he's got a great shot of making a good recovery and having a pretty good quality of life once he recovers.

I think of the face of the donor every morning when I go in to see this man. It's weird to feel so happy for the guy who got a new heart, and simultaneously feel sad for the kid who died and his devastated family. ICU's are a strange melting pot of emotion.

I would hope that anyone who isn't a donor, will consider becoming one. Sometimes it's the only silver lining to horrible accidents that claim lives. I doubt that it's much comfort to the family of this kid that was killed so soon after his death, but hopefully someday it will be--his death has dramatically improved the lives of at least 3 families (probably more, I'm not sure what happened with his other organs).

Also, very much worth the time it takes to create a living will. You can download forms on the Internet and fill in the blanks. Makes it a lot easier on you and your family if it's clear what your wishes are should you get in an accident or get really sick and end up on a ventilator in an ICU.