Author’s note: The following passage is from Chapter 6, “The Dreams,” of my book, Summer in the Waiting Room: How Faith, Family, and Friends Saved My Life. This is the 53rd excerpt in the blog series.
After I woke up from my induced coma later that summer, it took several months for me to understand that the events that occurred in these dreams were part fact and mostly fiction. According to a study conducted by the Stanford School of Medicine, ICU Psychosis is a condition “characterized by disturbances of consciousness, global cognitive impairment, disorientation, and development of perceptual disturbance” caused by numerous factors related to long stays in a critical care unit.
In other words, the strange and confined surroundings of the ICU combined with the sedative medication causes the patient to hallucinate as the brain tries to make sense of the sights and sounds of the ICU. My critical care doctor would later tell me that the medicine used to induce me into a coma was like a super high dose of LSD, and many ICU survivors have a difficult time distinguishing between the hallucinations and reality.
Medically induced into coma is different than a coma caused by a sudden shock to the body as in a car accident. The former is a deep sleep caused by medication and the latter is a neurological occurrence that significantly decreases brain activity. For someone in a deep sleep, the brain continues to function normally so the patient can unconsciously experience what is happening in the ICU.
From time to time, patients in this state may open their eyes for a split second resulting in a camera-like snapshot. Due to dementia caused by the restricted environment of the ICU and LSD-like drugs, doctors believe that the brain receives and records everything it sees and hears, but can’t process the episodes in an orderly manner resulting in vivid dreams that are fictionalized versions of actual events.
Regardless of the medical and psychological causes of ICU Psychosis, the resultant hallucinations are startling. A recent study published in BioMedCentral.com estimates that Post Traumatic Distress Order (PTSD) can affect as many as 63% of ICU survivors compared to 15% diagnosed in military combat veterans. No matter how you look at it, The Dreams played an integral role in my experience throughout the month of July.
The dream about me strapped in a straightjacket sitting in an office that resembled a navy ship while different characters in my life wandered in an out is typical of the more than a dozen dreams I remember clearly. Like the dream about Sandra and Fr. Francisco, most of the delusions I had were pure fantasy with a touch of reality related to my dire condition in the ICU.
When in recovery months later, I told Sandra about the dream in the navy ship’s office and she reacted with amazement as she remembered when Fr. Francisco visited me during the early days of my coma and prayed with us. Throughout Part II of this book, I share stories of The Dreams in the form of italics, as they relate to actual incidents in the ICU.
On June 30th, Sandra started talking to me in a daily journal so that she could share “all my (Sandra’s) thoughts as I sit here day after day to try to understand what is happening.” In the diary, she relates her most personal emotions during the three-month ordeal from the day she began to write through September 14th. The journal brings to life the myriad of sensations – fear, hope, and despair – that consumed Sandra that summer. Sandra relates conversations with doctors, family, and friends as she struggles to comprehend how her life and the life of her family suddenly changed course toward an unknown destination.
Late the first night she started writing in her journal, Sandra was helping the nurse sponge-bathe me when my oxygen levels began to drop dramatically. Still not quite in a deep sleep, I looked at her asking for help with my eyes as I stared at her with fear and confusion. Doctors were called in to calm me down and adjust the oxygen flow to my lungs.
Sandra wrote, “all I could do was put you in God’s hands. God knows that you are meant to be here because it is now 11:00 (PM) and you are doing better.” In her writings, her unfailing faith in God carried her though the challenges that came with each day.
The next day, doctors decided to increase the paralytic and sedative medication putting me into a deeper sleep to keep me from moving. They also increased the diuretic medicine to clear my lungs so they could have a better look to determine the cause of the inflammation and saturation.
Not to be outdone by the lungs, my heart continued to show alarming weakness. Before exploring more severe options to address my lung problems, the doctors performed an echocardiogram to measure heart function. The test confirmed that my heart continued to weaken and pump weakly with a 20-25% ejection fraction.
The doctor informed Sandra that he and his colleagues were analyzing all of the data and scheduled a meeting to discuss options the next day. In the meantime, he would connect me to a high-ventilation oscillator, a breathing device that enhances the effectiveness of a traditional ventilator.
The oscillator is a large machine about four feet tall with a recangular base and a block-shaped “head” that looks like a 1960s era robot. It pumps puffs of air into the lungs to open the airways so the ventilator can deliver oxygen to the body. Usually used on premature babies until the lungs are fully developed, oscillators are rarely used on adults and only under the most extreme conditions.
The doctor’s comments were brief, straight to the point, and unemotional. Nevertheless, his eyes looked worried and displayed an overwhelming sense of uncertainty. He and his colleagues really had no idea what was causing oxygen levels to plummet and my lungs to deteriorate so fast.
Once again, Sandra provided an update to an anxious waiting room, and once again, the waiting room, confused and concerned, began to murmur. Sandra asked her mom, sisters, Barbara, and George to join her in the next day’s meeting with doctors as the waiting room settled in for another long day.