A story about deja vu in the Intensive Care Unit:
A guy was on the ventilator (a machine that inflates and deflates the lungs for a person through a tube that goes down the throat). Suddenly, the oxygenation of his blood dropped. I listened to his lungs. Breath sounds on the right, none on the left.
An x-ray showed a complete white-out on the right hand side.
I called a bunch of people: senior doctors, the radiologist.
The radiologist said: he has fluid around the lung.
One of the senior doctors ultrasounded the lung and said: “There isn’t actually that much fluid around the lung. Probably there is a mucous plug upstream that is causing the lung to be filled with fluid.”
So the patient didn’t have fluid around the lung, he had fluid in the lung.
We increased the pressure that breathing machine puts into the lungs, and the oxygenation of this blood went back to normal.
Then the deja vu moment: we got called to see patient number 2.
He had almost the same picture: a complete white-out of a lung on chest x ray.
But the ultrasound for him showed that there is fluid around the lung (not inside the lung like the first patient).
Patient number 1 could benefit from removing the mucous plug, patient number 2 could benefit from draining the fluid around the lung.
These 2 episodes happened within a single hour. After that, I rushed off to do more mundane things: writing orders, checking labs.
I went home after this night shift, ate a bunch of ice cream, and passed out. When I woke up, I thought: that was really cool.
In medicine, the thing I lack is time. I’m always running around.
Life is really freaking cool. Space is great. It helps you say wow.