High Dependency. Snapshots from ICU.

Danny’s face appears next to my bed in the middle of the night.
“I need to turn you over.”
He watches me, concerned, for a few seconds. I look back at him, half asleep. I don’t want to be turned over.
“I’m comfy.”
For another few seconds he looks into my eyes and I am silently begging him to leave me alone. His compassion wins out. He massages the area of my bum which has been taking the pressure of my weight and leaves me alone. For now.

She is in her early teens, dressed in her best, and she walks through the ward alone, straight backed, staring straight ahead. She knows where her dad’s bed is and if she avoids looking sideways she will not see something horrible before she gets to it.

He is a member of the house staff and his work is clearly being done somewhere else but every time he walks past he has the kind of rhythm and confidence that comes from knowing what he does is important. Just watching him sashay past my bed makes me feel better.

A nurse has just given me a lethal injection in the middle of the night. I don’t know how I know that it is lethal but I do. When I realise that it has already happened and there is nothing that I can do about it I wake up in a panic. There is nobody by my bed.

The middle aged woman carrying a chair towards her husband’s bed is wearing a smart suit and shiny shoes. Her hair is immaculate. Her fixed smile does not reach her eyes. It is a defence against a world that has let her down. It shows anyone who sees it that she is all right, they are both all right, really they are. They will get through this. If she makes sure that everything that she can control is exactly as it should be everything will be fine.

I am having a bad night. There is a large mask sending hot oxygen across my face and droplets of warm water are running down the inside of the plastic surface. I am burning up. Behind the closed screen there are the random sounds of someone whose life is being fought for. I catch a glimpse of a grey, still face. There is no panic, no rush, just focused, intense activity. Then nothing. The lights are snapped off, the intensity evaporates and for a short while there is silence before quiet, secluded conversations and gentle encouragement. Louise comes to do my observations. I wonder how she is.
“You have all been working very hard.”
It’s a stupid thing to say but it’s all that I can think of. She says nothing- just brings a fan to cool me down. Death is not mentioned.

I am being washed all over by someone who has only just told me their name.

Something is very wrong. I have no memory of what has happened but I know that returning to consciousness to find a semi circle of cardiologists and nurses talking about you is never a good thing. Especially when the last- or is it first?- thing that you remember is a doctor’s voice saying “Oh shit”. I catch fragments of conversation. A pacing machine, heart rhythm, the number 200. Slowly it makes sense. My heart had stopped. For two minutes. That seems like a very long time. Is it long enough to count as being dead I wonder?
I am asked by one of the cardiologists how I am feeling.
“Scared.”
This is not quite true. I know I should be scared and that is why I say it but it’s all a bit too much like a Saturday night TV drama to take seriously. I am trying to work out what has happened and why- so are the doctors. There is no space in my head for fear.
“My dad has a heart rhythm problem” I tell them.
One of the team explains that they think the cause was the pacing machine picking up on the wrong part of my heart rhythm. I am grateful that he has listened and taken me seriously and- bizarrely- I am quite proud that my heart wanted to beat in its own way and not be dictated to by a machine.
The next day I tell one of the nurses who wasn’t there about it and he sticks his chin out and gives me a quietly impressed nod. When the nurse who was in charge of the ward is back on duty she tells me cheerfully, “we didn’t have to do much to bring you back.”
No…….. not much.

Rana looks at me anxiously. “Drink! Drink! Drink!” They keep telling me to drink more. How did that get to be so hard?

The lady who makes the toast has long dark hair and a bright smile. She puts real butter on the bread and marmalade, spreads it carefully and brings it to me cut in half with a napkin over it to keep it warm. It is the best part of my day. There are no small jobs here.

I am fascinated by the fact that my entire bedding can be changed and I can be given a bath without me ever having to get out of bed. The sheer number of people who are taking an interest in my well being is overwhelming. I always have my own special nurse- a rotating day and night team of them who seem to have arrived from all over the world just for my benefit and groups of doctors who come and talk about me.

Jiao is new. She has been looking after me and she is standing at the end of my bed being praised after carefully watching my side drain being put in.. The nurse in charge is telling one of the consultants that she is doing very well. She stands listening shyly, trying not to look too full of herself but she is very happy. This is not an easy place to get used to and there is a lot to remember. I add my two pennyworth- not that anyone is that bothered..
“Jiao is lovely.”

I have no idea what is being put into my system through the lines in my neck and hand. Blood yes, and fluids. Potassium- I know that because one time they bring it to me to drink orally and it tastes strange and horrible. There are tablets too, diuretics, painkillers, warfarin, I’m not sure what else. I am carefully told what they are each time,but I forget immediately. It doesn’t seem to be any of my business.

The cheerful physiotherapist comes and stands by my bed. He wants me to wriggle my swollen feet and raise my hands. Soon I am standing up, holding onto a frame and gently marching on the spot. He smiles happily.
“You’ll be racing Usain Bolt soon.”
I look at him grimly.
“I think he might win.”
We both laugh.

I have a rash. I look like an illustration from a nineteenth century medical textbook. Everybody is fascinated by this and comes to look at it and talk about it. Ideas are bandied about. It seems like an allergy. What have I been given? (Don’t ask me) What have I not had before? I struggle to remember- I seem to have been down here in ICU/high dependency for a lifetime. Finally one of the ICU doctors declares, “Well it is as it is- we can’t mobilise you down here.” They will have to sort it out upstairs.

Ayuub is glad that I have come round from the anaesthetic after my fluid drainage. It has taken too long. He has been watching me all day. Now that my breathing tube has been taken out he wants to know about me. Am I married? Do I have children? What do I like to eat? What is my profession? When I tell him that I have no children he is sorry but consoles himself with the fact that I must be a rich woman. His children have done well and he is proud of them but they have given him grey hairs. He is excited because his sister is visiting from far away and he is going to cook her chicken, fish and prawns.

This is a nice dinner. Roasted vegetables, cauliflower cheese, roast potatoes and rhubarb crumble. Someone is encouraging me.
“You’re enjoying that aren’t you.”
“Did you not want the meat?”
It is my second stay in ICU and the first time that I have thought food was a good thing since my surgery. My plate is clean.

Danny reassures me.
“You will go home. It may take a few more days but you WILL go home.”
I believe him.

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