After watching the interview with Alfonso Bassave and Gabi Heras (only available in Spanish), there are many things to reflect. More that interview, it was a conversation of two human beings, two professionals speaking “defenceless” of feelings and emotions.
An idea has not stopped turning in my head. A word was repeated on several occasions during the conversation: FEAR.
Of course patients have fear, panic literally at times, and their families suffer from many fears and uncertainties.
But…What about the intensivist? Are afraid the intensivist?
If the answer depended on me, the answer would be: Yes, and I’m not talking about being afraid as any person to get sick, losing a loved one or to his own death. No.
I mean to have fear in your work.
Fear of not be able to diagnose in time a patient, to fail in a technique at a crucial moment, to make an incorrect decision, having not studied enough of a patology, to be too tired to thinkg of a complication arises…
Suddenly you are in the center of a “scenario”: initial attention to a serious polytraumathized, or massive hemoptysis, or airway obstruction; notice of cardiac arrest on any ward of the hospital.
When the intensivist attends any of these calls, he/she is the last resort and therapeutic step: all eyes on you and waiting for instructions. “What should we do, Doc?, Are we going to intubate him? Would you like a iv line? Blood pressure is not detected! Should we phone to the family? Do we prepare some drug? Do not upload the saturation! She is still bleeding!”.
Fear of not to intubate the patient, or that the pacemaker does not stimulate, fear to make a pneumothorax, fear to MAKE A MISTAKE.
In the regional hospitals, there is a single intensivist on shift, no more ICU physicians: no residents, no cardiovascular surgeon, no neurosurgeon, without interventional Radiologist, no pediatric ICU, without ENT, no gastro.
Fear of not being prepared for every ocassion.
There are two calls that, when they appear in our phone, cut our the breath: gynecologist and pediatrician. An emergency obstetric or pediatric, are perhaps the most distressing situations for the intensivist in a local Hospital. FEAR not to be able to do anything.
But it´s impossible to work there, you could think… and I would say that in this way it´s impossible almost live.
We must talk about it: fear is not embarrassment or a sign of weakness.
FEAR is a necessary feeling.
We must develop and learn self-control resources, striving hard to be prepared, studying, training, learning self-help techniques… Be absolutely honest with oneself: this is difficult sometimes, very hard sometimes, but it’s my job. I have prepared to do so, I have tried to be prepared, everyone trust in me at this time and is one of the things that I like most in the world.
Dra. Maria Rojas
Intensive Care Physician.
Hospital Comarcal Infanta Margarita, Cordoba