​Times of crisis 35 – remembering ICU

I will never forget the time I have spent working in intensive care departments. As a counsellor and rehabilitation therapist this was never my chosen field but in my physiotherapy course I was trained to do respiratory work in ICU and could be called in to work there at night. This pattern of working rather enhanced my view of the place as a strange twilight zone. I would arrive often in something of a dreamy state and find myself somehow trying to empathise with the dreamy world of semi-conscious patients. There was a lot of pain and grief mixed up with the heavy sedation. Many of the procedures on the patients were very intrusive – needles, tubes, suction. 

Then there was always the rude awakening coming for me, putting on the gloves and working out the read-outs from the instruments before launching in. Here, on the whole, I needed to be focussed and scientific. I so much admired the permanent staff, their level of experience meant they were able to be so clear in this respect and at the same time so compassionate. For me it was always hard to concentrate, to keep my mind on a situation that was frequently also shocking, especially having come from my other work where I was training myself to be sensitive and empathic, to form a holistic view of the patient that put them in the centre of the picture. 

But there was always a moment, a moment that I did not understand so well then but understand much more clearly now, when I would establish my mindfulness. This was always when it came to the solid, physical lifting-and-handling part of the job. My mind would firm up along with the body somehow. When this happened I found myself both present, robust and still able to reflect and relate. I found myself where I needed to be as the carer.

Then, looking on, it seemed to me that most of the patients needed, in contrast, to be guided away from reality into their inner world to find a refuge. I kept remembering a time during my years as a psychologist when a very close friend of mine ended up a patient in ICU. I went to see him every day. My friend was an artist and endowed with the most exceptional imagination. He was able to picture himself as a cartoon character, able to be squished one moment and pop back up the next. He was full of humour and seemed to have found a place where he was aware of his body as an image in his mind and at the same time beyond concern for his body. In his own way he was still in there fighting for his life, he could still follow the guidance of the nurses and do what he needed to do, but he kept a light touch on the whole affair. To me this looks like a good place for the patient to find themselves in.

Overall then, remembering ICU, I am reminded how life can demand such fluidity of mind from us all. One moment we can need to be solid and firm, the next as light as air. If we can master all this we will truly be free of attachment.

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​I offer this for your reflection

Ajahn Kalyāno
http://www.openthesky.co.uk