Days 23 & 24:
(6/11, 6/12)

The first part of the week we’ve spent in the ICU unit, and it has been much different than I expected. The unit is extremely small- only 8 beds- and is much less busy compared to US hospitals. Yesterday there were two patients in the unit and then they both got moved to the wards. And then today there were two more patients and a third arrived late in the afternoon. The unit is eerily quiet, and the machines don’t really even make noise, which is also different from what I remember from the states. Since RMH is a pretty small hospital, it doesn’t get many major traumas, so the ICU’s main source of patients is surgery. The first 24-30 hours after surgery are the most critical, and all patients are required to spend those hours in ICU being closely monitored before being moved to the wards.

Our time in ICU has actually been pretty boring. At least from what I’ve seen, most of the work is just maintaining the patients’ condition. One of the doctors told me she thinks ICU is one of the easiest fields because it’s common sense and just about regaining and maintaining homeostasis- what’s wrong, what’s causing the problem, and what can be done to fix it? So far that has been nothing more than monitoring airways, extubating, taking blood pressure, cleaning wounds, and setting up IV’s. This stuff is so basic that I don’t even have that many questions, making it hard to connect with the nurses/doctors and difficult to know what to ask them. I would never wish sickness upon someone, but I guess in some way I do wish there would be a little more action on the unit. But such is the ebb and flow of a hospital; last week it was crazy, this week is quiet, and probably it’ll be crazy again next week.

Aside from the long boring days, I did have a really nice chat with one of the women doctors this morning. We ended up talking about the unequal gender ratios in India and how infanticide is a now-illegal but still very common practice. We were also talking about how many times doctors in villages are seen and treated as God, but that in hospitals it is different; in hospitals, patients expect to be cured when in all reality mistakes do happen. Homeopathic medicine is also an issue because while it is usually harmless and can supplement actual care, many homeopathic-trained people also practice allopathic medicine (without actual training), leading to a whole range of problems. Patients then find their way back to allopathic doctors, expect to be cured, and get angry when there are issues. Finally, we talked about how a lot of times in India doctors may withhold information or make certain decisions for the patients, but that the doctors in ICU (and this doctor specifically) are making a concerted effort to give patients and their families all information available, and then allow them to make treatment decisions based on that information. This doctor shared a quote, and we both agreed it is the way doctors should handle themselves:

“From inability to let well alone; from too much zeal for the new and contempt for what is old; from putting knowledge before wisdom, science before art, and cleverness before common sense; from treating patients as cases, and from making the cure of the disease more grievous than the endurance of the same, Good Lord, deliver us.”

~Sir Robert Hutchison