Broken

I take care of “broken” people. Both broken, physically and emotionally.

Due to the nature of my specialty, I deal regularly with people who overdosed and those who attempted to commit suicide.

This past week, we have a lot of them. Every single night we have at least 2 admissions to our ICU of attempted suicide by drug overdose. There’s one that even slashed her wrist besides taking medications. It was full moon after all.

I am not superstitious, but I believe there is a real science behind the connection of the cyclical phases of the moon and human’s crazy behavior. Just like the gravitational pull of the moon affects the ocean tide, maybe it can influence our mind too. The human’s brain is 75% water anyway.

Most of the times our drug overdose admissions are “trivial” overdoses. They took a handful of pain or sleep medications as a cry for help, with the so familiar line of “I just want to escape from my problems” or “I just want to take a long sleep.” Though many will also claim, “I just want to end it all.”

Most of these overdoses just needed to be closely monitored for several hours in the ICU as they sleep off the effects of the drugs they took. When they sober up, we call the psychiatrist to evaluate them whether they are clear for discharge or transfer to the Psych unit.

However there are some who are “serious” with their attempts, that they overdosed with an awful amount of drugs or took highly toxic substances that they present to our ICU half dead. They have multi-organ failures, and would require infusion of medical antidotes if there’s any, be placed on life support, including mechanical ventilator, cardiac and circulatory support, and even dialysis, if the medication or poison they took can be dialysed out. Few of these gravely ill patients would slip through our fingers and die despite of our best efforts.

Taking care of overdoses and attempted suicide patients is my least favorite in the line of my job. Why?

First of all, as I mentioned above, most of them don’t really need ICU care, as they just require time to sleep it off. But I guess they needed to be in a highly monitored bed in case something goes wrong. So many times it just add to the burden of the ICU staff who are already overloaded in caring other critically ill patients.

Secondly, for those who are “serious” in their suicide attempt and comes to us almost dead, after we work our tails off saving them, they are not even grateful to us when they recover. They are even bitter. Why? For the obvious reason that we prevented them from getting to their ultimate goal, which is to die. It is a thankless job.

Over the years that I have been an ICU physician, I have observed that our admission of drug overdoses and suicide attempts seems to be increasing. Has our society gone so cold and uncaring that many among us feel so lost and so unloved, that they are willing to do foolish things just to get the care and attention they hunger for? Maybe it is the world that is broken. Maybe it is all of us.

As a health care professional, it is my duty and my obligation to care for these people when they come to our ICU, irregardless of how “stupid” their acts seems to be. I’ll listen to their stories. I’ll reassure them. And if care and attention is what they want, deserving or not, I’ll give it to them.

Even though these “broken” people think that the world is so indifferent and no one seems to care, but when they leave our ICU, I can honestly say to them, I cared for you.

(*image from emaze.com)