(III) Inhabiting the Labyrinth - Part one

Carolie’s full-blown entry into the labyrinth was of Wagnerian proportions.  The next morning I returned to the ICU to complete all sorts of paper work needed to transfer her to Sydney.  Bizarre flashes of the chopper attack scene in the film Apocalypse Now popped in my head. It is passing strange where the brain takes you under duress.  It was not until around 5pm that Carolie was flown by helicopter to RPA.  It was a lowering sky, full of forebodings of stormy weather.  She had more than enough to worry about without storms.

A lifetime of flying in small machines in difficult weather and terrain had left me with a visceral fear of small flying machines.  However, I was not afraid for myself on this occasion as I did not have a place on the chopper and would drive up to Sydney the next morning.  One part of me was relieved but my worries for Carolie intensified.  Ironically, she likes flying and, in any case, was so sedated as to be completely unaware of the flight.  

 A flight transfer is subject to the same operating constraints as an ambulance transfer, which avoids unnecessary speed and bumps wherever possible. Storms can play havoc with the instrumentation of a helicopter - flying in unsettled weather is only done out of necessity.  After clearance, it took around two hours, as the pilot had to dodge storms en route.    

Carolie arrived at the RPA Neurological ICU around 7pm.  The nurse manager on duty recalled these events as very dramatic as they were on stand by for ages awaiting her arrival.  She was one of the more sympathetic inhabitants of the labyrinth; a highly experienced nurse with a healer’s touch of empathy and compassion.  The ICU nurse manager cohort was a fount of knowledge throughout and shared their wisdom willingly.  I learnt more from discussions with these fine folk than from the medical hierarchy throughout the whole journey.  I had less instructive dealings with senior nurses in more distant byways, but that is for a later discussion.

The ICU space in RPA is truly labyrinthine.  There are four units side by side with no discernible differences to provide a guide for the uninitiated – a fractured mosaic of interconnecting islands linked by corridors that lead off in several directions.  Well-spaced beds are interspersed at regular intervals, surrounded by dispensing and monitoring machines with a backdrop of utility outlets such as oxygen.   

Each unit has a specialty discipline – with attendant nurses, registrars, specialists and consultants, and calibrated facilities.  Every treatment space within the mosaic is redolent with varieties of human trauma, conveyed via pain, coma, fear, worry, despair and resilient hope.  Walking by the beds, one catches glimpses of these mixed fortunes and the many and varied people caught up in the labyrinth.  It is an intensely human landscape but unfamiliar to most of us.

A typical ICU station

Isolation rooms are available for highly vulnerable patients.  There are central monitoring stations staffed by administrative support (during the day), registrars and nurse managers.  Itinerant specialists, consultants and ancillary staff such as radiographers, dieticians and various attendants cruise in an out of these spaces,  checking CT scan and ultrasound pictures, angiographs and other critical data and preparing patients for moves to other areas of the hospital.   

Anaesthetists parachute in occasionally to ready a patient for a procedure.  Suddenly there is a flurry of activity in a confined space as small teams go to work unhooking life support to recalibrate it for transport aboard the labyrinth’s main form of transport, the hospital bed.  Smaller, mobile machines take over as these unwieldy contraptions shape shift down corridors, disappearing through massive swing doors and into gaping lifts.

To be continued.....