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What I learned from the ICU (other than medicine)

Michelle Ramirez, MD
Physician
February 5, 2018
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This week I had some particularly emotionally tough cases at work, and it got me thinking about life in general and how, in spite of having a tough job, I have learned so much from it.

When I think of childhood diseases, there are the ones that are chronic, the ones that let you process that your baby is sick and has a potential life-threatening condition. You have weeks and months to absorb it. Then there are the ones that occur suddenly, in the blink of an eye.

I am talking about the child who is alive and well, perfectly normal, smiling one second, and the next he/she is gone. These are very often devastating brain injuries. This week I had two such cases.

Families will often bring pictures of their pre-devastation child to decorate the walls of the room. You see the laughter, the family celebrations, and the special moments, all around their bed.

You, unfortunately, have seen enough to know these children never come back to be exactly how they were before. You go through the motions, and try everything you can to see if, maybe, this one will be different. After all, who the hell am I to destroy their hope? Do I know everything? Hardly.

As the days go by, we slowly guide them towards acceptance that the smiling boy or girl they remember is gone. It’s heart-wrenching. It drains you. It’s the stuff my worst nightmares are made of: What if it happened to my kid?

5 life lessons from the ICU

Don’t take anything for granted and enjoy every second

Every second that you have with your child, your parent, your family and your friends is a gift. Acknowledge this and savor every second. Inhale your baby’s smell as often as possible, tell your friend how much you love them, don’t be afraid to take a leap and try something new. So many people don’t have that or get cut short from spending time with their loved ones. Life goes by in the blink of an eye and sometimes it goes unexpectedly, so make sure you enjoy every second. You never know if it could be your last.

Get your priorities straight, figure out what matters and cut the bulls#@%

This really annoys me. I see so many fights and arguments going on between family members when their children are sick. At times, these surface with the child’s illness, but other times these have been going on for years. Often it is over trivial things.

When I look at the big picture, and my time on this earth, I think: Am I really going to spend the time fighting over money or my perception of something that I considered offensive? Or will I try to make the most of it, talk about things and put our differences behind us?

Some relationships don’t work out: your current spouse may not be your forever partner. However, how important is it that you try to make his/her life impossible? So many times we keep hurting each other, purposefully. Nothing good comes of that. So, let it go. If you don’t like that person, then don’t hang out it with them.

Skin thickness: thicker is better

In order to accomplish the previous point, you have to be able to not take things personally. Don’t get offended so easily.

By virtue of working in the ICU, I have had ample opportunity to develop thick skin. I work with plenty of surgeons, who historically have difficult personalities and not a lot of filter.

Also, families have different coping mechanisms. Some are extremely sweet and grateful; others fight you on every decision, others go through denial and still others decide to blame you.

This last one is the hardest. Anger is their coping mechanism. In my time as an ICU physician, I have received more than my share of insults. Toughest one?

One mother questioned my fitness as a mother and stated that my child must “hate me.” That one stung. However, her son was dying from cancer. If I took it personally, I would make it about me. Nothing in that room was about me. I said I was sorry she felt that way and left the room. Later, I returned to report time of death.

The ICU isn’t for the thin-skinned, and neither is life. Take things in stride, don’t make it about you and don’t take it personally.

Keep calm

Life is going to throw at us all sorts of situations. In the ICU, things can change from one second to next. You can’t walk into the emergency screaming. You have to be calm and level-headed. You have to keep your cool.

We need the same thing in life. Whenever a crisis comes into my life, I think: “Deep breath, relax and don’t freak out.” Take a step back and survey the situation, so that you can take appropriate, rational action.

Pick your battles

In medicine, just like real life, some things are absolutely necessary, and some are negotiable. Some parents refuse a treatment. Some of these are key to the child’s well-being. When dealing with this, I only push for those that are absolutely needed for the child’s health.

This is the same modus operandi I apply to real life. Is something worth going head-on with someone? If I just want to be right, I let that fight go. I don’t engage. It’s better to save that energy for the ones that I truly care about.

And in the end, remember

Young, old, rich, poor, and across all races: we can all get sick. We are all vulnerable. Don’t let anyone intimidate or belittle you. Super important for us women when working in male-dominated fields.

So, go ahead, dream, then go after those dreams and make it happen.

Michelle Ramirez is a pediatric intensive care physician.

Image credit: Shutterstock.com

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