Before I moved to the Upper Peninsula 10 years ago, I was working in the Cardiac Intensive Care Unit and the Medical Intensive Care Unit at Northwestern Memorial Hospital in Chicago. The MICU in particular tended to have a patient population of very ill patients in a slow downward spiral.
I remember one woman in particular. She had had a minor surgical procedure on her hand at an outlying suburban hospital. Unfortunately her orthopedic surgeon failed to perform the proper level of medical screening before proceeding. As a result she suffered a severe myocardial infarct ("heart attack") in her recovery that eventually led to her transfer to our ICU where eventually we removed her life support and she died at age 58 after having "trigger finger release" surgery.
Gradually each of her body systems began to shut down and I watched as her husband and 21 year old son struggled with what was occurring before them. I was unusual amongst ICU nurses in that I didn't mind caring for the patients who were slated for removal of all life support. I wasn't afraid of the emotional issues in helping the patients' families understand what was occurring and then supporting them as they came to the decision to withdraw life support.
I bring this up today because I am feeling a bit like those patient families as I try to follow what is occurring with the economy. You see, family's would often ask the doctors: "How's she doing?" This was a big picture question - is she going to pull through, will she come back home to us, is she dying? The doctors, particularly intensivists, are often uncomfortable with acknowledging the high probability of death many of these patients are facing. The doctors would then answer in little question answers. "Well, yesterday he was on 95% FiO2 on the ventilator and today we were able to bring that down to 90% FiO2 - so he's doing better." What they fail to tell the family is that prolonged time on a ventilator at FiO2 levels above 50% cause barotrauma to the lungs resulting in the need to remain ventilated for weeks if not months before weaning off (if ever). They will focus on a slight improvement in a creatinen level and tell the family that she's improving - but don't explain that the renal failure (kidneys) continues at an alarming rate.
I listen to all the pundits and economists and politicians discuss the economy and I am completely confused. Is this a recession that will be gone by the year's end? Is the patient doing better? Is this a calamity approaching if not surpassing the Depression of the 1930's? The roller coaster ride of good news, bad news, ambiguous news and what these "tea leaves" reveal is leaving me bewildered.
I want to know how the patient is doing and I can't even find out if he's in the ICU facing death or on a regular unit with a serious infection. This leaves me completely uncertain on how to react. I know of a few individuals who have lost their jobs, but overall this doesn't feel real to me. In fact, the opposite is happening, it's starting to feel like just another reality tv show - where the facts are juiced up to create drama from one week to the next. That is not to say that I am feeling that the recession isn't real - the folks on The Biggest Loser are clearly obese and getting thinner as the season progresses, but the drama is often manufactured and carefully edited to meet the needs of the viewing public.
Perhaps I have too many false images of what economic meltdown will look like - too many snapshots from flipping through Life magazine compilations, too many viewings of Frank Capra movies and such from Hollywood. Maybe the depth of this is a creeping slow cancerous kind of thing - everything continues to appear healthy on the surface for many months. Healthy cells will slowly continue to wither and die and cancer cells will get million -dollar -plus bonuses. In the end, that's how Capitalism works. Will we ever learn?
I remember one woman in particular. She had had a minor surgical procedure on her hand at an outlying suburban hospital. Unfortunately her orthopedic surgeon failed to perform the proper level of medical screening before proceeding. As a result she suffered a severe myocardial infarct ("heart attack") in her recovery that eventually led to her transfer to our ICU where eventually we removed her life support and she died at age 58 after having "trigger finger release" surgery.
Gradually each of her body systems began to shut down and I watched as her husband and 21 year old son struggled with what was occurring before them. I was unusual amongst ICU nurses in that I didn't mind caring for the patients who were slated for removal of all life support. I wasn't afraid of the emotional issues in helping the patients' families understand what was occurring and then supporting them as they came to the decision to withdraw life support.
I bring this up today because I am feeling a bit like those patient families as I try to follow what is occurring with the economy. You see, family's would often ask the doctors: "How's she doing?" This was a big picture question - is she going to pull through, will she come back home to us, is she dying? The doctors, particularly intensivists, are often uncomfortable with acknowledging the high probability of death many of these patients are facing. The doctors would then answer in little question answers. "Well, yesterday he was on 95% FiO2 on the ventilator and today we were able to bring that down to 90% FiO2 - so he's doing better." What they fail to tell the family is that prolonged time on a ventilator at FiO2 levels above 50% cause barotrauma to the lungs resulting in the need to remain ventilated for weeks if not months before weaning off (if ever). They will focus on a slight improvement in a creatinen level and tell the family that she's improving - but don't explain that the renal failure (kidneys) continues at an alarming rate.
I listen to all the pundits and economists and politicians discuss the economy and I am completely confused. Is this a recession that will be gone by the year's end? Is the patient doing better? Is this a calamity approaching if not surpassing the Depression of the 1930's? The roller coaster ride of good news, bad news, ambiguous news and what these "tea leaves" reveal is leaving me bewildered.
I want to know how the patient is doing and I can't even find out if he's in the ICU facing death or on a regular unit with a serious infection. This leaves me completely uncertain on how to react. I know of a few individuals who have lost their jobs, but overall this doesn't feel real to me. In fact, the opposite is happening, it's starting to feel like just another reality tv show - where the facts are juiced up to create drama from one week to the next. That is not to say that I am feeling that the recession isn't real - the folks on The Biggest Loser are clearly obese and getting thinner as the season progresses, but the drama is often manufactured and carefully edited to meet the needs of the viewing public.
Perhaps I have too many false images of what economic meltdown will look like - too many snapshots from flipping through Life magazine compilations, too many viewings of Frank Capra movies and such from Hollywood. Maybe the depth of this is a creeping slow cancerous kind of thing - everything continues to appear healthy on the surface for many months. Healthy cells will slowly continue to wither and die and cancer cells will get million -dollar -plus bonuses. In the end, that's how Capitalism works. Will we ever learn?
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