As an intensive care physician I care for many patients who are critically ill, require life support and are at high risk of dying. Our hope is that by supporting patients we allow time for infections to settle down, medications to work and their bodies to recover and eventually remove the need for life support. Once ICU specific therapies are no longer needed, we transfer the patients to inpatient wards where they continue their (often long) journey to ongoing recovery and hopefully discharge from hospital and continue to live their lives. But we dont see what happens after they leave us.
I specifically remember the case of a 19 year-old who had testicular cancer that had spread to almost every organ. As the cancer spread and his body and immune system became weaker...he developed a severe infection or sepsis that caused his blood pressure to fall, his kidneys and lungs to fail requiring every form of life support we could provide...and that was barely keeping him alive. Although the infection was treated, the cancer was preventing him from recovering and the likelihood of dying grew each day. After many discussions between the ICU, medical oncology and the patient's family...a decision was made to start chemotherapy. Normally never provided in people this sick as the chemotherapy itself can cause organ failure. But what other options did we have.
As the chemo started working, he initially got worse but we kept supporting him as much as we could, worried that he could die and sometimes thinking perhaps that would be better given the toll on his body. But then he started to get better, and better and eventually we were able to take him off life support. Now he was still so weak and confused..would he ever be able to live like a 19 year old should. Eventually he was stable enough to transfer to the ward and our job was done. He was alive but how would he live.
I will never forget the day he and his mother walked back into our ICU. So much taller than I remember and way more muscular. He came to thank us and to learn what happened to him during his stay and who helped him. I was so thankful to see him. That was the reason I went into medicine; to make a difference in people's lives. Seeing him reminded me of my purpose and the joy in helping others brings.
We started a program in the ICU after that. We reached out to ICU survivors and had them visit us. It makes a huge difference for the ICU team.