We used to think that successfully coming out of the ICU means escaping the ghost gate, but 80% of the ICU survivors who returned from life and death did not live a normal life, delirium, depression, anxiety, brain fog...... Various severe syndromes accompany them for the rest of their lives.
Clearly, the development of critical illness does not end when patients leave the ICU, and their treatment is not limited to the hospital, but extends to the family and community.
Success in severe disease cannot be measured solely by survival statistics, but should be measured by whether or not the patient's quality of life is maintained or restored.
It is urgent to pay attention to the quality of life of people who have recovered from severe illness.
In the long and rich history of medical development, critical care medicine is an emerging discipline, which can be traced back to only more than 150 years.
In those days dominated by old-fashioned critical care philosophies, the goal of doctors was to save lives at all costs. They keep the patient deeply sedated with mechanical ventilation and drugs to keep them relaxed. Patients are immobilized in hospital beds, isolated from family and friends, and often fall into a state of delirium.
Now, more ICU doctors are realizing that their role is not just to save lives, but also to focus on the quality of life.
Some critically ill patients feel like a shackled prisoner while in the hospital, "I didn't commit a crime, I just ask you to help me recover." ”
There are also patients who feel fear and extreme loneliness when they are on mechanical ventilation, and at the same time have a sense of captivity. "It's like being held in solitary confinement."
For many critically ill patients, leaving the ICU does not mean the end of treatment, but the beginning of another. After they walked out of the hospital, they still lived in this world with diseases that could not be completely cured. They need the help of a doctor and the understanding and support of family and friends.
Focusing on the quality of life of critically ill patients is an ongoing process, and both doctors and patients' families need to constantly learn and explore new ways to give them care and support to better meet the needs and expectations of patients.
As Wes Elie, author of Every Deep Breath, says, "Doctors need to face all the problems their patients face." ”
Behind the harsh reality, Dr. Eli understands the meaning of his work: not only to witness and guide patients in the treatment of diseases, but also to infuse more compassion that extends to himself in every moment, so that patients can be respected as "whole people".
This book is not only about the fragility of life, but also about humanity and hope. This book is the culmination of 25 years of ICU nursing reform by Wesley Eley, a pulmonology and critical care specialist, and will completely change the status quo of intensive care with "rescue rate" as the primary observance.
When a doctor becomes a family member of a critically ill patient
The book "Every Deep Breath" is a bit brutally real: as a doctor who has been working on the front line of intensive care for a long time, Eli has to watch his daughter be admitted to the ward he knows best......
"I sat near the high springboard and watched her get in and out of the water, climb the ladder, walk onto the springboard, and then jump back into the pool with a smooth movement like an otter...... My child fell off the springboard, which was almost 5 meters above the ground. With a bang, I saw her head hit the concrete floor, blood splattered, and her body curled up and slid from the edge of the pool into the pool......"
It was a dark day in Wesley Eley's life, and he uncovered the scars in the book and recalled the details of his daughter's admission to the ICU-
The 8-kilometre journey from the ambulance to the hospital seems to have no end in sight. The first responder reported to the hospital: "We have a 6-year-old girl here who is going to the emergency room and is currently diagnosed with head trauma with convulsions. ”
When arriving at the hospital, everything was so familiar. Although he had seen this scene every day before, this time it was different. Eli entered the ICU as a parent and saw her daughter lying in bed, "wearing an oversized blue hospital gown, looking so thin and helplessly connected to a heart monitor and many intravenous tubes."
Eli replayed the details of the day over and over again in his mind, hearing the "thump" over and over again, each time terrifying him with regret and pain.
"I realized that I was completely powerless to control how things unfolded. This destroyed me. ”
After the role is reversed
I reached empathy with people who were "afraid of doctors".
Entering the ICU ward for the first time as a patient's family member rather than a doctor subverted all of Eli's perceptions of medical treatment, life, and doctor-patient relationship——
"When my patients and their loved ones came into the ICU, I thought I knew enough about what they were going through, but now I realize that I don't know enough. The patient's family needs me to keep their loved one alive. They do, just as I pray for my daughter to live. ”
When the roles are reversed, Elie empathizes with the "scared doctor" and tries to put the patient's family in perspective.
This empathy allowed him to find himself and his original intention of becoming a doctor.
Doctors often witness distressing things in the ICU every day, and it is difficult to beat the shock of fear.
But he tried to keep in mind that even in the midst of fear, he could still see the glimmer of hope. "The human spirit is stronger than any medicine, and that's something we need to nourish through work, games, friendships, family."
How to solve the biggest dilemma facing modern medicine?
With the development of modern medical treatment, human life expectancy has been extended, and the cure rate of diseases has increased, creating many miracles of life that are dying and resurrected.
But the high level of science and technology in medical care also makes us think about a question: are we ignoring the feelings of patients as living "people"? Has critical care medicine changed lives, or has it destroyed them?
In Every Deep Breath, Dr. Eli collects the true stories he has witnessed in the intensive care unit over the past 25 years, as well as the most cutting-edge research in the field.
In his eyes, the biggest dilemma facing modern medicine is no longer medical technology, but how to treat every "person" more humanely. In a highly technological world, there is a greater need for humanistic care and compassion.
Real life is not always as beautiful as imagined, and there are many helpless sorrows and pains in life. When it is embodied in accidents, illness and delirium, it is even more embarrassing.
What can reading a book about life and death bring us?
Maybe it's to help us establish a view of life and death that "nothing is important in life", and not to be discouraged because of frustration when we encounter setbacks.
Eventually, we will understand the meaning of life – that life is precious, and perhaps by keeping it aware that life will eventually end, we will be able to better appreciate the idea of being alive.