The beat goes on
Having a weekend off is bliss. Having a weekend off and sleeping through most of it is bigger bliss. Having a weekend off, sleeping through most of it, and being devoid of any responsibility whatsoever is the biggest bliss of all.
I played my 'get out of work' card when Elyssa (the other student on the rotation right now) came back Friday after missing three days. She worked the weekend to make up for lost time. Sweet. Plus, I left work around 3 on Friday afternoon. 'Twas most excellent. Of course, I celebrated in grand fashion by coming home and falling asleep for three hours. I slept in on Saturday, grocery shopped, and went to the boat show for a little while with Chris. I then came home and fell asleep while watching TV. I slept in today, did the laundry, and catnapped while watching TV. I haven't been outside since last night.
Last week finally got back to normal.
That girl that may or may not have attempted to commit suicide (there are conflicting reports that indicate she may have been pushed) donated her organs early Friday morning. Her parents, along with the team of doctors involved, decided that she wouldn't likely survive her injuries and even if she did, it wouldn't be much of a life worth living and certainly wouldn't be the kind of life she would have wanted to live. When Dr. T (the SICU attending) and her dad were discussing this Thursday morning, I couldn't be in the room. I admit freely that I get emotionally involved and I'm almost glad I do - it keeps me human. The organ recovery folks were called in and they got started on all the paperwork and blood work. Holy moses is there a ton of paperwork involved! Her parents came back to see her, along with her siblings, later that day.
Since she wasn't declared to be 'brain dead', she would undergo donation after cardiac death (DCD). This means that her organs would be recovered after she was extubated and allowed to pass 'naturally'. There are some qualifiers to this. Death has to occur within 50 minutes of extubation for the organs to still be viable. To make sure this happens (that doesn't sound right but it's true), there's an algorithm the organ recovery folks follow and they also do some bedside testing (taking the patient off the vent for a certain amount of time, yadda yadda). If in following the algorithm it's apparent that the patient will expire in this window then they are considered a candidate for donation. She 'passed'. Also, since she was going to be DCD, her heart wouldn't be able to be used (I believe this is more ethical than medical). Her lungs would also not be used because she had severe pulmonary contusions as a result of her injuries. It was decided that they would go for liver, kidneys, pancreas and corneas. Also, you have to wait five minutes after clinical signs of life cease - just in case (and no, I'm not making that up).
If her parents/family wanted to be with her at the time of death, there would have been two ORs arranged: one so the family could be with her and the other for the recovery. After the patient expires, the family is literally whisked out and the patient whisked into the other room. Her family had seen her earlier and didn't wish to be present, so only one OR was set up. She was prepped and draped. The transplant teams were waiting literally in the wings scrubbed in and ready to go. They can't be in the room at the time she's declared because it's an ethical issue - no circling of vultures. Dr. T extubated her. She passed away within ten minutes.
And now? Now there are six people who have been given a second chance at life because she gave hers.
Tomorrow brings the second-to-last week of SICU. And frankly, I couldn't be happier. I'm learning enough but I don't think I'm getting out of it what I wanted to. That may change, as Dr. M is on this week and Dr. L is on next week. We shall see.
Moment of Burrito: "A happy life consists not in the absence, but in the mastery of hardships." - Helen Keller
I played my 'get out of work' card when Elyssa (the other student on the rotation right now) came back Friday after missing three days. She worked the weekend to make up for lost time. Sweet. Plus, I left work around 3 on Friday afternoon. 'Twas most excellent. Of course, I celebrated in grand fashion by coming home and falling asleep for three hours. I slept in on Saturday, grocery shopped, and went to the boat show for a little while with Chris. I then came home and fell asleep while watching TV. I slept in today, did the laundry, and catnapped while watching TV. I haven't been outside since last night.
Last week finally got back to normal.
That girl that may or may not have attempted to commit suicide (there are conflicting reports that indicate she may have been pushed) donated her organs early Friday morning. Her parents, along with the team of doctors involved, decided that she wouldn't likely survive her injuries and even if she did, it wouldn't be much of a life worth living and certainly wouldn't be the kind of life she would have wanted to live. When Dr. T (the SICU attending) and her dad were discussing this Thursday morning, I couldn't be in the room. I admit freely that I get emotionally involved and I'm almost glad I do - it keeps me human. The organ recovery folks were called in and they got started on all the paperwork and blood work. Holy moses is there a ton of paperwork involved! Her parents came back to see her, along with her siblings, later that day.
Since she wasn't declared to be 'brain dead', she would undergo donation after cardiac death (DCD). This means that her organs would be recovered after she was extubated and allowed to pass 'naturally'. There are some qualifiers to this. Death has to occur within 50 minutes of extubation for the organs to still be viable. To make sure this happens (that doesn't sound right but it's true), there's an algorithm the organ recovery folks follow and they also do some bedside testing (taking the patient off the vent for a certain amount of time, yadda yadda). If in following the algorithm it's apparent that the patient will expire in this window then they are considered a candidate for donation. She 'passed'. Also, since she was going to be DCD, her heart wouldn't be able to be used (I believe this is more ethical than medical). Her lungs would also not be used because she had severe pulmonary contusions as a result of her injuries. It was decided that they would go for liver, kidneys, pancreas and corneas. Also, you have to wait five minutes after clinical signs of life cease - just in case (and no, I'm not making that up).
If her parents/family wanted to be with her at the time of death, there would have been two ORs arranged: one so the family could be with her and the other for the recovery. After the patient expires, the family is literally whisked out and the patient whisked into the other room. Her family had seen her earlier and didn't wish to be present, so only one OR was set up. She was prepped and draped. The transplant teams were waiting literally in the wings scrubbed in and ready to go. They can't be in the room at the time she's declared because it's an ethical issue - no circling of vultures. Dr. T extubated her. She passed away within ten minutes.
And now? Now there are six people who have been given a second chance at life because she gave hers.
Tomorrow brings the second-to-last week of SICU. And frankly, I couldn't be happier. I'm learning enough but I don't think I'm getting out of it what I wanted to. That may change, as Dr. M is on this week and Dr. L is on next week. We shall see.
Moment of Burrito: "A happy life consists not in the absence, but in the mastery of hardships." - Helen Keller