Like Diamonds Under Pressure

Updated: May 5

I can see the lockdown working. We are getting less and less admissions, and more and more discharges. People are getting better. I am hearing patients voices for the first time in two months. My intensive care unit (ICU) had become a very sombre place, now I can see the light flooding back in.

One patient has stuck in my mind. I was overseeing their care, along with two other patients, over two day shifts. By this point they had been in hospital for over three weeks. For the first two weeks they were sick. Very sick. One of the sickest patients we had. For a week they were proned (rolled onto their tummy to improve ventilation) and unproned. For thirteen days they were kept asleep.

They are now awake. Despite having to have a tracheostomy (a hole made in the neck, with a tube inserted into it to aid weaning from ventilation and intensive care rehabilitation), they were coming on leaps and bounds. They no longer required a ventilator. You cannot talk when you have a tracheostomy as air no longer passes your vocal cords. However there is a special attachment, called a speaking valve which can be attached to the tube in the neck and allows the patient to speak. They were doing so well on the second day, the physiotherapists and I decided to give it a try.

Their voice was quiet and raspy at first, but they soon got into the swing of it. Their sister called later. I said someone wants to speak to you. The patient did not have the strength to hold the phone to their ear, so I held it. They did have the strength to speak to their sister. I guess they had a lot to catch up on. I could hear the joy in my patient's voice. I could also hear the relief. Relief their family was okay and that they themselves were going to be okay. They joked it would take a lot more to get rid of them. They were not planning on going anyway anytime soon. I barely kept it together. Once they started talking, we could not get them to stop. I had this overwhelming sense of pride. I played a small part in helping them get their voice back.

Later in the day they wanted to know what had happened to them. The patient, their bedside nurse and I had a long talk. They could not remember. We talked about how it was normal to not remember things. We talked about how those memories may or may not come back. We went through old notes to see what had happened day by day. We acknowledged that the memories that may return, may be disturbing. "I have been to hell and back, haven't I?" said the patient. "You really have," I said.

Recovery from a critical illness is long, not just physically but emotionally. Many who recover from ICU admission suffer from post traumatic stress disorder (PTSD). Therefore this patient has a tough journey ahead. I can say for certain however, it will be an upward journey, despite the bumps along the way. I noticed the patient had a tattoo of a diamond. It was beautiful and I told them this. They said high pressures make a diamond, this makes them unbreakable. Like you I said. They only had got the tattoo a week before they got coronavirus.

Since then, they have been discharged from ICU and I am pleased to say these stories are becoming more and more common. That's thanks to you. However, now is not the time to become complacent. Social distancing is saving lives, and I can see it happening. I want to help more people get their voices back, but it requires a team effort. We will beat coronavirus together. We are unbreakable, like diamonds forming under pressure.


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