I am past my one year and I feel it is necessary to highlight what I believe is my largest hurdle in my recovery. There were ten days of my life that I have no memory of. From before I left Washington Regional by helicopter until ten days later when I became aware that I was in ICU at Cox Hospital, I have no memory, yet during much of that time I was according to others, awake, I interacted, and to most others they believed I was mostly normal. To my family those early days in ICU must have been difficult because my wife has reported she saw a man who was difficult, mean, and sometimes cruel. One of her favorite memories that she has repeated to others in front of me more than once was her telling the nursing staff that I was the devil and they had to fix me because she wasn’t taking “that” meaning me, home with her. ICU Psychosis is real but not something that any of the doctors and nurses I have talked with wants to acknowledge. Maybe that is because when one is in ICU that is the first time these doctors and nurses come in contact with their patient so they have no markers to aid their knowledge as to the true nature of a person. Family and close friends would notice the difference but they are not qualified to diagnose ICU Psychosis so the patient and the family are on their own or at least my family and I were on our own to figure out why I behaved so difficult during some of my stay in ICU and this update is to document how this failure to diagnose and treat the lingering impact of ICU Psychosis impacted my recovery.
I am a retired but battle hardened criminal investigator. I began my law enforcement career working deep undercover narcotics investigations. One can’t appreciate what it is like to try to sleep in a strange location surrounded by drug dealers with a handgun under your pillow not knowing if you will be drug out of your bed and killed because you had been discovered. I finished my law enforcement career investigating the homicide of a young mother whose daughter and boyfriend had murdered, bent her in half, stuff her in a burn barrel and setup her body ablaze. I have had a wide range of experiences that most people will never have in their lifetime and to survive like many in law enforcement I have had to try to understand how a normally everyday average joe can suddenly turn into a deranged murderer. The human mind can sometimes be like a light switch, one moment it is on, and the next it is off living in a place where control and reasoning don’t live. Because of my experiences I wasn’t that surprised when I learned that during some of my stay in ICU I behaved sometimes badly. I was a deranged mentally ill person. My brain was under attack and trying to respond, my body was ful of all kinds of drugs and it was anyone’s guess how they impacted me. I was taken from my familiar surroundings and placed into an unfamiliar darken room where I was tied to my bed and was being attended to by strangers. I certainly wasn’t physically able to hurt anyone but my wife can tell you that prior to my Aneurysm I sometimes destroyed my bedding at night because I do fight back in my dreams when I am confronted with danger so given my experiences, training, and background it should come as no surprise to anyone who knows me well to know I would not react well to being caged in ICU. It was necessary to my survival but try to tell that to a man in my condition at that time you might as well have been talking to a mental ill person because at that time that is exactly what I was.
My family may have been distraught, they had no idea how badly my brain had been damaged by the Aneurysm but based upon what I have been told, my family was concerned enough and were not receiving the answers from the doctors and nurses that they needed so they had to go on line to seek information about my condition. Cox has an excellent public Internet and one of my sons came upon ICU Psychosis. My wife said when they asked the nursing staff if I might be experiencing such, they received a luke warm response a "could be" and looking back on it I am not surprised, dealing with brain damaged patients probably had become so much the norm that they would have been surprised if I had behaved differently but given that most families have never had that experience or training, one can image how lost my family was. I was lucky, my youngest son is a medical student and my older son a teacher so both are gaining very broad experiences that aided them in tracking down a possible explanation for my behavior. My wife was so distraught that she contacted my personal physician who because of distance hadn’t been brought into my treatment and she was given advice that I now would caution against.
I have full faith and trust in my personal physician, he has been critical to my recovery, his expertise in brain injuries has aided me greatly in my recovery but his single bit of advice to my wife about my ICU Psychosis was perhaps the worse treatment possible from the view of the patient. A year after my Aneurysm neither of my two sons have said much about my ICU Psychosis. With both of them it has been, “yeah you had Psychosis, get over it and get on with your life” kind of attitude. Both seem to understand the true nature of my condition but my doctor told my wife to write it all down, to keep a written record and show it to me later. Why? What possbile good coudl this do me? How could it aid my recovery. What it did was put me through months of guilt and blame for something I had no control over. My doctor should have told my wife, “yes brain injured people do some shocking things and what you need to do is not take any of it seriously or personal and never speak of it and don’t tell the patient anything about it”. Doctors and nurses and family members of brain injured people should heed my warning. Knowledge that I experienced ICU Psychosis played no positive role in my recovery. This knowledge caused me to feel
guilty and less interested in living. There was a time I considered taking my life becuase the quilt was so great but I think my law enforcement experience and the consult of a close friend whose daughter experienced brain injury is what pulled me through that very difficult time in my recovery. I think my sons must have understood this because they never mention it but I have heard plenty about this notebook and that my doctor has prescribe its creation. I was a very sick man fighting for survival and the last thing I needed to hear as I left the hospital or during my recovery was how out of control I had been while in ICU. This served no positive role in my survival or recovery; there was no valid reason to make me aware as if I had a choice and choose to act this way. I don’t blame my wife for doing it, she was desperate to explain why I was behaving so disagreeable, but doctors and nurses should be trained not to just treat the patient’s body but also the mind of the family who will be taking care of the patient during recovery. How would you feel to have survived a near death experience and be struggling to recover only to have the one you have spent almost all your life with reveal your worst behavior not just to you but to others and to have it recorded as a constant reminder of the son of a bitch you were? My wife did this because that is what she was told to do, but from patients view point of view if you care about the person and their recovery, don’t do it.
Let me be very clear, this post isn't to blame anyone, everyone was doing the best they could given the knowledge they had availabile. I don't blame my wife or my doctor but want to warn others to not do it as it lhad a negative impact on my recovery and how I will view this event the rest of my life. The sole purpose of my post is to inform others so they will have additional information to consider before they go down that same course of action. ICU Psychosis is real and as one who went through it, don’t worry about the patient, it isn’t likely they will remember it, worry about the family and caution them not to keep a written record becaue the patient don’t need the extra burden. Waht we need is understand and anyone who feels offended by the patients behavior may need treatment to get over it.