I see ICU…

No sooner they injected contrast substance into me for brain angiography, I started convulsing. Of course, medical protocol at that point of time demanded my brain angiography. I do understand protocol as I am a veterinarian, but every protocol demands certain amount of preparedness, involving very small but equally important interventions.

After seeing off my two little daughters for their school, I climbed the boundary wall of my compound for some chore and I fell down. I was taken to the lone tertiary care institute of Kashmir. I had a decreased level of consciousness on arrival, what they call GCS 8. In medical lingo, I was diagnosed as traumatic subarachnoid hemorrhage (tSAH).

I had suffered head trauma. I was expecting oxygen inhalation far before it was actually given to me. As I was hypertensive, having GCS 8, I was expecting intra-tracheal tube and ventilator back up before my CT angio, to prevent aspiration and other complications. Unfortunately, I was intubated (securing intra-tracheal tube) only after I aspirated my vomit as I convulsed following the contrast injection and slipped into coma. One of my relatives in Secretariat used his good offices for getting a bed in ICU allotted to me; much later than I had slipped into coma.

In ICU, I felt I am in any other ward, though monitors and ventilators surrounded me. My organ system was intact before I was shifted to ICU and, more importantly, I believed to recuperate in ‘INTENSIVE CARE’ UNIT of the hyped institute. I reconciled about the medical laxity I faced before I slipped into coma by hoping it to be compensated in ICU. Consented by my father, successful brain surgery was done on me. However, I never imagined that I was gradually losing my other intact and uncompromised organ systems, one by one, nearing my end.

Yes, pharmacological therapy (medicines) is primary in any serious condition, but it never undermines the importance of non-pharmacological interventions in such sensitive cases. Medicines work only when other non-pharmacological interventions are taken care of. Barring few, I found the helping staff conscious about preventing themselves from acquiring infections from patients but least bothered about transmitting infections from one patient to another.

I, including most of other patients in coma, developed severe infections in ICU. Though infections were treated with appropriate antibiotics, it was just administering of antibiotics devoid of other aggressive interventions like foolproof cleanliness, sterile environs, proper care of indwelling catheters and intra-tracheal tubes, suction of secretions and so on. No immediate and sincere measures were taken to prevent the transmission of deadly infections between patients in ICU. I witnessed many VIPs and their security men barging into ICU with their shoes on. Meanwhile, one of the patients aside me in ICU was airlifted to Delhi where same drugs prescribed here were given to her. What helped in her speedy recovery from acquired infections was actual ICU care and dedication. Yet, my relatives believed in the efficiency of ICU belonging to our “premier” institute! I continued enduring the hazardous mismanagement.

Except for few, most of the doctors and paramedical staff were more concerned about handover and takeover, just a head count of patients, bereft of actual professional acumen and humane nature, which I as a doctor for animals never expected from the doctors of humans. My heart was sinking, my creatinine and bilirubin was surging. Despite it, without dose adjustment, full dose of various high end antibiotics and anti-fungals, to treat my acquired septicemia, were being bombarded into my compromising body. My attendants were being told to get bagfuls of antibiotics and other medicines, so much so that my dialysis became unavoidable.

Bit by bit, I was losing the working of my organs. And my family and friends were losing their faith in the fatal ICU. They finally decided to shift me outside state for better treatment. They talked about it with one of the ICU doctors, an Associate Professor in Critical Care. Shockingly, he behaved like a desensitized doomsayer, uttering— “Now he is not in a position to be shifted, we are waiting for him to die”. 

For fifteen festering days, I suffered neglect; and I breathed my last. Perhaps, I left behind a lot to educate ordinary people about life. For us, life is precious. However, it usually gets undervalued under the shallow weight of white coats and stethoscopes!

(This piece is dedicated to Dr. Hanief Bhat, the veterinarian, who passed away a week ago).