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The I.C.U. Is Not a Pause Button

Posted on 08/31/2015

NY Times — With my elderly stroke patient’s back arched and his head tilted back, too many angles of his skeleton were on display. A nose covered in thin gray skin sliced the air like a shark fin, and beneath it his mouth hung open. He didn’t look like he was resting.

Another nurse walking by put it bluntly, as nurses tend to do. “Is he alive?”

Of course he was alive. We could both see the safe numbers and steady waves marching across the monitor. Only the measure of the oxygen circulating in his blood hovered low. He had stabilized and had been taken off his ventilator, but his body wasn’t rising to the challenge of consciousness and physical independence. For a few days we had used CPAP (continuous positive airway pressure), a device that pushes oxygen through a mask and is one step away from intubation. But CPAP is meant for people who are awake and able to pull off the mask if, for example, they throw up and the machine begins to push vomit into their lungs. He was no longer a good candidate for it, and now we were trying not to use it. Of the many devices available to support breathing, none of them was a good solution for him.

Read the full piece from the Time’s Opinionator here.