Stethoscopes and Balloon Art: Why I Value 'Wisdom Outside of Medicine' in the ICU
Nice to meet you, I am "Dr. J" from the ICU. I will be writing about "the stories that lie beyond saving lives."
When you hear the term ICU (Intensive Care Unit), what kind of scene comes to mind?
Patients connected to many tubes, sleeping deeply under sedation. That used to be the norm.
However, the "standard" we aim for now is different.
Even with a ventilator, patients wake up, exchange written notes with family, and sometimes perform rehabilitation on the bed.
We aim not just to keep the heart beating, but to help them return to their "original life" as quickly as possible.
To achieve this—something beyond just "keeping them alive," or what you might call "plus-alpha care—requires extraordinary passion from a multidisciplinary team of doctors, nurses, and physical therapists.
And even if saving a life is ultimately not possible, we strive to ensure that the conclusion of their life is as warm and fulfilling as possible for both the patient and their family.
Nice to meet you. My name is "Dr. J."
I work as an intensive care specialist in that very environment of ultimate team medicine.
"Why would a busy intensive care physician go out of their way to write on note?"
You might be thinking that.
The trigger was thedecisive lack of 'white space'in the clinical setting.
What is being lost in the field of life-saving
We medical professionals all enter this world with the high aspiration of "wanting to help someone."
But what is the reality?
Endless tasks, increasingly complex medical equipment, friction in human relationships...
"I want to listen to the patients more," "I want to be there for their families," but the time and mental space for that are eroded by the daily torrent of work.
"We saved their Life. But were we able to protect their life (Life) and their living (Living)?"
When I stop and think, such questions sometimes pierce my heart.
In the "vertical society" where doctors are doctors and nurses are nurses, we are enthusiastic about cramming in specialized knowledge, but we have surprisingly few opportunities to learn about team management or DX (digital transformation) to streamline operations.
The paradox is that the places requiring the warmest dialogue have the least amount of breathing room.
I am convinced that the only way to solve this is to bring in wisdom from outside of medicine.
The identity of Dr. J
As an intensive care specialist, I value not only medical knowledge and techniques (hard skills), but even more sosoft skills like 'dialogue,' 'management,' and 'DX'.
Sometimes, I even make balloon art as a gift for pediatric patients who are spending their time feeling anxious.
This is because I want to make the time they spend in the ICU not a "scary and painful time," but a time where they can feel at least a little bit at ease.
In terms of animal fortune-telling, I am a"Pegasus,"and my strength might be my free-spirited thinking that is not bound by stereotypes.
What I am aiming for is theredefinition of 'QOL.'
The term QOL (Quality of Life) is often used in medical settings. I perceive this as something much more multi-layered.
Life (Biological): Life support as a living organism.
Life (Human): The story that the person has woven.
Living: The daily life that continues after discharge.
And we must not forget the QOL of us staff members who provide the care.
If the caregivers are exhausted, there is no way they can provide good support.
Here, I will write down three prescriptions.
In this note, I will not be explaining textbook medical knowledge.
Instead, I would like to share 'perspectives' and 'techniques' to slightly change the landscape of the clinical setting.
1. 'Decision-making support' to reach a convincing solution
There is no single correct answer in discussions about 'life-prolonging treatment'.
The wish to 'have them live even one day longer' and the feeling of 'not wanting them to suffer' are both precious. It is not a dualism of whether life-prolonging treatment is good or bad.
What is important is whether the patient themselves, their family, and we as medical professionals can be 'convinced' by the choice.
However, dialogue in tense situations is truly difficult. Everyone is moving forward while feeling lost.
I hope to help make that 'dialogue' even a little better by using frameworks such as ACP (Advance Care Planning) and SDM (Shared Decision Making).
2. 'Team building' to keep from breaking down
Moving away from a rigid, pyramid-shaped organization toward a workplace where everyone can speak without fear.
How can we implement concepts like psychological safety and work engagement in the extreme environment of the ICU? This is a theme I want to think about together with not just the leadership, but everyone struggling in the field.
3. 'Intellectual production techniques and DX' to create time
To avoid using 'being busy' as an excuse, I will borrow the power of technology.
Using Obsidian as a thinking tool and generative AI as a sounding board. I will share concrete hacks to master the waves of vast information and create 'margin' in time and heart for learning.
Conclusion: Walking together, while remaining incomplete
I have laid out some high-minded things, but I myself am also just one human being swaying between ideals and reality.
I do not have any perfect answers.
That is precisely why I want to make this place a 'forum for dialogue'.
More dialogue in the medical field. More efficiency. And above all, more human warmth.
If you are harboring a small sense of discomfort in your daily work, thinking 'something is wrong' or 'it could be done better'.
Please, try thinking and acting together with me.
Dr. J