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Introduction to the ICU: My grandfather’s passing gift

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SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

This week, I began to think of death as a friend. My grandfather was hospitalized on Mother’s Day, and by the time my parents called me on Monday morning they couldn’t tell me anything more than, "He’s in the ICU with multiple seizures. They’re taking him off ventilation tomorrow." Reaching for the knowledge I’ve spent all year chipping away at textbooks to acquire, I asked about neurologic exams, autonomic drugs and heart conditions I knew he was at risk for.

"I don’t know, Little Doctor," my mother kept saying, reminding me that none of these words were a part of the conversation for family. A day later, sitting with my family in the hospital room, I realized the real conversation was about peace, humor and love. My family wasn’t fighting death because they could see it already in Poppa. Poppa’s ribs were broken from CPR earlier that week, his breath came in hard-earned gasps and his blood pressure hovered around 80/44.

Alternately fascinated with the activity of his accessory respiratory muscles and heartbroken at the image of my stepdad standing at the side of Poppa’s bed, resting his hand protectively on his father’s forehead, I thought about how death has a presence. There wasn’t a single one of us in that room who wasn't certain Poppa was going to leave us in a matter of moments.

I sat quietly in the back of the room watching our broken old man who looked so little like the jolly Poppa I had gotten to know over the past 10 years. If this is what patients look like in the ICU – barely human anymore – I wondered how I would have tried to relate to them on my rotation if I hadn't first been to the ICU with my own loved one.

The answer came the next day, at our open-casket wake. Poppa looked like himself again. This is how I will remember him, resting peacefully, almost ready to sit up and tell us another joke. I still can’t believe how the coroners re-infused my grandfather’s body with his personality after it had been stripped away during his medical emergencies.

Aside from the memories and family that Poppa gave me, I’m so thankful that his parting gift to me was helping me understand how dehumanizing the ICU can be. I hope that when I go to clinics in a year, I'll remember the difference between the man I knew and the man I saw on a hospital bed.

Natalia Birgisson is a first-year medical student at Stanford. She is half Icelandic, half Venezuelan and grew up moving internationally before coming to Stanford for college. She is interested in neurosurgery, global health, and ethics. Natalia loves running and baking; when she’s lucky the two activities even out. 

Image by Niels Olson

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