Rana Awdish: In Shock
Selected Excerpts
“I resurfaced, overtaken with a sudden fear. I felt a breath delivered, without having drawn it myself, and shuddered at the sensation. It was like trying to breathe with your head out the car window; the force of the air made movement of breath impossible. I was wholly dependent on machines; I understood the magnitude of catastrophe this signified.” (pg. 32)
“In my muddied consciousness, I struggled to maintain alertness long enough to piece together clues: the warbled texture of speech, the bloat of my body, the gurgle of fluid in my lungs. In those days before my memories were coherent, I believed I had been drowned.” (pg. 33)
“I only knew that when I was dying, the very last thing I heard was ‘She’s circling the drain here. We’re losing her.’ And that statement could have been the last thing I ever heard.” (pg. 127)
Discussion Questions
Dr. Awdish’s story offers a window into the experience of being critically ill in the ICU. What stood out to you in her account?
Dr. Awdish intervenes when a resident speaks carelessly around a sedated, critically ill patient. What can we learn from her story about communication in the ICU?
How can we, at the individual level and at the broader health systems level, humanize care in the ICU? What would ideal ICU and post-ICU care look like?
Reflections from #MedHumChat
“Definitely makes me think of all the seemingly benign conversations I have over the heads of sedated patients. About food. About the weather. About being tired or bored or annoyed at being on call. It is so easy to believe that you are not heard.” —@danielalamasmd
“I found the contrast between the deeply human words in one piece (panic, darkness, gasped, cried, etc.) & the detached medical jargon of the other piece (intubation, dilator, transfusions, etc.) compelling. Can language be a barrier that distances docs/patients?” —@MrAleoSays
“My favorite residents as a med student, esp neurologists, modeled speaking to sedated pts as though they could hear us. I realized when I started doing it myself how much it affected *me*, and helped me feel a relationship even with pts too sick to ‘meet’” —@eemoin
“What we tolerate becomes the standard which we accept” —@RanaAwdish
“My perspective is one of brutal honesty and openness. I have suffered and continue to suffer immensely. I have also been touched by deeply caring people who have ensured my survival when I could not myself.” —@brookevitti
About this #MedHumChat
In Shock was paired with You Can Stop Humming Now, a book by Dr. Daniela Lamas for a #MedHumChat discussion April 24, 2019 exploring Humanizing the ICU.
We were honored to be joined by special guests Dr. Rana Awdish, MD, Dr. Daniela Lamas, MD, and Brooke Vittimberga. Dr. Daniela Lamas, MD, is an author, pulmonary and critical care doctor at the Brigham & Women's Hospital, and faculty member of Harvard Medical School. Learn more about her here. Brooke Vittimberga uses her personal experience with acute myeloid leukemia and bone marrow transplantation to advocate for improving survivorship and quality of life for young adult cancer patients. Learn more about her here.
The pieces for this chat, along with the discussion questions, were curated by Colleen Farrell.
About the Author
Dr. Awdish is an author, critical care physician, and faculty member of Wayne State University School of Medicine. After suffering a sudden critical illness herself, she has devoted much of her career to improving empathy through connection and communication. Learn more about her here.