Okay so before we continue let me give you some more context. Intensive care, as the name suggests, is intense: it’s where the really sick people go; the ones in imminent danger of dying, or who need a lot of medical intervention to prevent them deteriorating. Most people don’t stay long; intensive care beds are in high demand and short supply- getting people stable enough to be moved to where they require less support is the name of the game. The majority of the patients in intensive care are also either sedated, very ill, or both. If you work in ITU your patients often don’t talk back. All of this meant that I was a strange outlier. I was a doctor, I was awake, I was young, I talked/mouthed back (usually politely) and I was medically pretty stable- just very weak.

At work, prior to my injury, communicating with senior consultants in intensive care would be a rare thing- in fact I don’t think I ever had to call ITU in QMC during my brief stint as a baby doctor. You see back then I was a new doc-on-the-block, fresh out of the womb, green as grass; generally doctors that fresh are derided as being close to useless in the general medical hierarchy. Okay, maybe not useless, but the equivalent of a peasant: I was good at tilling the fields but wouldn’t be trusted with any lordly duties. So if I ever had to speak to any of these people I’d probably be sweaty palmed, close to incontinent, very stressed with my main goal being just not looking stupid. Going further into the bizarro world that is the hospital ecosystem is outside the scope of this post, but what all of this meant was that I was now a peasant hanging out in the palace being waited on by the nobility rather than the other way around. I took advantage of this odd role reversal in many ways, one of which was anointing some of the consultants with interesting nicknames that I dreamt up while staring at the ceiling. 

One of these was “Unprofessional Paul”. There wasn’t actually anything unprofessional about Paul at all; he was a very kind and capable doctor who was deeply involved in my recovery. He just happened to come and see me (probably on his day off, now that I think about it) in a hoodie and jeans, and me being me made a gag about his professionalism and work attire. I think this sort of bravado was a way of keeping me sane and maintaining some normalcy when everything else was so tilted; I was still venturing out of the hole I was in every now and again.

My favourite of all of my inventions was the “Queen of the Wean”. I was very pleased myself when I came up with this one. The Queen was a very senior consultant who oversaw my progress moving off the ventilator. Every day the amount of help the ventilator would give me would be reduced so I was doing more of the work myself; I was training to breathe again in a different way. This structure and constant improvement was so vital to my sanity; it gave me something to aim for every day, and it was something that finally I could work on to help myself- I was not completely helpless, completely useless, it wasn’t all in the hands of fate. In the beginning I would do more work for five minutes. After just five minutes of breathing, which I had taken for granted for all of the 23 years prior, I was exhausted. Even through the haze of sleep deprivation, medication and grief I remember being alarmed at that feeling; working to pull my diaphragm down to drag pitiful morsels of air into my hungry lungs, panic setting in as they cried out for more oxygen that I didn’t have the strength to give them. Then the ventilator- my plastic, sterile enemy that I wanted rid of so badly- would save me, taking over and allowing me to rest. This battle would continue day after day, from five minutes to 10 minutes to half an hour as I grew stronger.

The photo is from early March; I had been in intensive care for a few weeks. The staff rigged up a portable ventilator so that I could go outside. You can see that even after just a few weeks the injury was taking its toll. I was wheeled through the hospital, down corridors that I had walked maybe hundreds of times, past the Costa coffee that I had spent so many hours in, past so many wards that I had worked on. I felt like a ghost revisiting my old haunts. I was still so frail that I could not sit up; I recognised these places from the ceilings alone. Because of the tracheostomy I was breathing through my neck; when no air flows through your mouth and nose you lose almost all of your sense of smell and taste- the feeding tube in one nostril probably didn’t help either. I had not eaten or drunk anything for weeks; I vividly remember coffee being the first thing I had actually smelled in what seemed like years. 

Being outside was a strange experience. I couldn’t taste the fresh air. I couldn’t feel the air on my skin. I could only lie flat and stare at the sky. It was almost like watching a slideshow; first slide ITU ceiling, second slide clouds and grey sky. But it didn’t matter. Getting outside was the very beginning of a long journey. Escaping from intensive care for just half an hour (which was all I could manage) now meant that the walls of my world had expanded from a bed in ITU- not by much, but they had all the same. All of these things showed the beginning of progress; and you only need to see a little to start to see a lot.