Is it Safe?
When it comes to stress positions, sleep deprivation and drugs, the torture techniques we adopted from the enemy in the last war have nothing on what goes on at most modern intensive care units.
Imagine being strapped to a gurney, humiliated, drugged and disoriented, bright lights burning incessantly overhead, strangers sticking you with needles and shoving tubes down your throat, no food, no sleep, no water for days and days and days … Welcome to Nelson 5 CCU at Johns Hopkins Medicine!
I’m not faulting the individual doctors and nurses that work the place, but somehow the system designed to save lives and care for people evolved into a high-tech torture chamber. The only thing they were lacking was the evil doctor from Marathon Man who drills holes in your teeth …
Would it be so difficult to swing that spotlight over, just a bit, so the patient is not getting the 3rd degree all night long? Does the intern have to shatter the patient’s exposed nerves by slamming the metal clipboard onto the bed rail when he shouts out his greetings at 2 AM ? (not that you’d know what time it was).
Do you think maybe you could have a little sign somewhere in the patient’s field of vision saying something like:
“No, you’re not in Hell. You’re in the ICU.
Today is Tuesday, April 11, 2002.
You’ve been here for THREE WEEKS”
∞
I stole a book from one of the Hopkins libraries, Matt Groening’s “Work is Hell.” I had intended to return it when I was done, but now I’m keeping it.
I was down there in the library to try to learn about Pam’s medical situation. I wanted to be able to 
ask the doctors intelligent questions. I looked up mitral valve and learned that it is so named because it resembles a bishop’s mitre hat. It is essentially a check valve, which allows blood to flow through in only one direction.
When there is negative pressure the valve closes—unless of course one of your mitral valve leaflets has been ripped from its base and is “flapping in the breeze” and “prolapsed in to the atrium.” Then you have what Hugh Calkins described as “complete flail,” which means the valve is blown wide open, resulting in “severe regurgitation,” so that blood that should be pumping out to the aorta is being sucked back into the atrium.
Up in the EP Lab, they’d figured that out with a stat echocardiogram, employed after forty five minutes of futile tug of war between doctors and Pam’s heart strings. The echo report reads:
“severe mitral regurgitation with a highly mobile mass attached to the posterior leaflet of the mitral valve consistent with ruptured papillary muscle.”
I give Hugh Calkins credit for his use of imagery. “Flapping in the breeze.” Indeed it was, like a semi-detached flag in a hurricane:
∞
I spent a lot of time in the library, and the more I read about the procedure, the more I began to realize that this doctor did not know what he was doing—and that he had not been telling us the truth.
