Monday, April 04, 2005

Medical ICU

Today was the real start of MICU for me. I was postcall on change-of-service on Saturday, and hence the team let me go home at 11am, after I had spoken to them about the patients. And I had Sunday off. So that left me with today.
Walking to the entrance of the medical ICUs, I had a sense of dread. Intensive care unit. Sickest of the sick, many of them on mechanical ventilators, vasopressors keeping their blood pressure up. One and one half feet in the grave.
This place reputedly has the 2nd largest ICU in the country. 8 intensive care units in this hospital alone (medical, surgical, cardiac, neuro, pediatric, neonatal etc). The MICU has 24 beds. Filled to the brim for most of the month. My internship MICU rotation was easily the toughest month in my career, with me questioning my faith, strength and abilities for most of the month. For most of the month, I was depressed. I kept waking up at 4am in a cold sweat even when I wasn't on call.
Strangely enough, this morning, on my first day back in the MICU, this time as senior, I woke up again at 4am. Except the difference was I woke up to pee, and was able to go back to sleep. I told myself I wasn't nervous. But I have to admit, walking into the unit today, rounding on the sickies got me anxious again. I tell myself this time things will be better. And that I've learnt a lot more since that difficult month 2 years ago. And I thank God that my upcoming endocrinology fellowship will have NO in-house call, especially in the ICU. Pity those poor saps who wanted to do a critical care fellowship!
My first MICU call tomorrow. Only time will tell. Wish me luck, and pray I won't wake up at 4am in a cold sweat again.