Beyond the Doors of the ICU

-Written by Dr. Bhupinder Singh, MBBS

TW: Death, Critical Care

One fine morning, as I was heading towards the ICU, I was stopped by a tall young man wearing a long woolen coat. I saw a dark, strong face with a soft smile and teary eyes. His face looked familiar. Before I could recall this man’s appearance, he said to me with his hands on his chest, “Thank you doctor for putting your heart and soul into the care of my mother; she died early in the morning. I am blessed to have you in my mother’s care.”

My mind completely shut down as I heard those words. One part of me was overwhelmed, and the other part was confused. Overwhelmed by his mother’s demise and confused by his gratitude, I felt my heart pumping rapidly beneath my ribs, and a thick layer of fog covered my eyes. I had no words to say. I thought I’d forgotten all languages. My hands started sweating, and my feet felt heavy. In no time, he started walking and soon left.

I was standing in the corridor, all alone. The entire flashback of his mother being admitted to the ICU started running through my head.

‘She was brought in unconscious with no recordable blood pressure. Her hands were cold and clammy. All we were told was that she had had diabetes for 20 years and had stopped eating for 3–4 days. She was in shock, septic shock; her TLC was 36,000; she was not producing enough urine; and her kidneys had already given up with rising levels of blood urea and serum creatinine. We started a noradrenaline infusion and sent blood and urine cultures before starting antibiotics.’

I could see myself coming out of the ICU and explaining to him his mother’s condition.

“Sir, her blood pressure is unrecordable… We have started blood pressure drugs; she is in shock, and there’s infection in her blood. Her condition is critical. I can understand that it’s hard for you; please stay strong, sir.”

I could recall seeing him standing behind the doors of the ICU, waiting for our team to tell him what was going on inside.

“This will be extremely difficult for you, sir… Your mother is gasping for air… She needs intubation… She cannot protect her airways any further. We need you to decide for her.

I will be with you during this phase.  Trust me, sir, we will do our best.”

He would always tell me, “Doctor, I have full faith in your team. Do what is best for her.”

The doors of the ICU hold two parallel worlds around them. That day I found the connecting piece—empathy.

Empathy allows one world to penetrate into the other. Empathy connects hearts across closed doors; it melts away the barriers!

An increasing number of research articles show empathy can reduce pain, anxiety, and fears, encouraging empathy-based care. The smallest expressions of empathy make huge, lasting impressions and open the doors for acceptance. While death is unavoidable, empathy has the potential to empower us.

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