I’m finally off the MICU, and into … the CCU! The difference, however, is that whereas the MICU patients are multi-organ failure train wrecks, most of whom are dead before they hit the door, CCU-ers have (usually) just one problem: their heart. I find it a lot easier to apply my tiny brain toward one organ; good thing I’m gonna be a specialist! (That plus the brain is, of course, the best, most complex, most fascinating organ in the body.)
Looking back, I think the thing that really broke me in the MICU was not the hours or the patient burden (though those did contribute). It was the fact that nothing we did made a difference. We’d flog one person who lived, we’d flog someone else with the same syndrome who died. The ancient Greeks had the Fates, weaving their tapestry and snipping threads without warning. I’m starting to believe that the Fates, these days, hang out in the MICUs of the world.
And that’s the thing, really. We look for logical, scientific explanations for what’s going on, get all wrapped up in the trend of someone’s potassium (replete! replete!) and we try our best to piece together a story. But when you’re back to Moment Zero, there’s always a leap, a totally unexpected and unfathomable event. I understand the toxidrome, but what prompted the overdose? (He lived.) I understand West Nile, but two days ago, this ventilated, unresponsive, vegetable was gardening when she got bit, unluckily, by a mosquito that squirted a virus into her blood. (She died.)
So I get now why all those 16th century poets were obsessed with carpe diem. It wasn’t just about getting laid (although it was about that too); in a time of plagues and fires and dying in plain view at home instead of shunted to hospitals and nursing homes, carpe diem makes perfect sense.