Opinion
My dad spent three weeks in ICU. This is what I learnt about our health system
Ruby Kraner-Tucci
ContributorI wasn’t prepared for the rollercoaster I was to ride when my dad became suddenly and critically ill just two months ago. I didn’t meet the ride’s height requirements and I hated the upside-down loops.
After being rushed to his closest private hospital in Melbourne, my 57-year-old dad spent three terrifying weeks in the intensive care unit, where he eventually died.
Ruby Kraner-Tucci with her dad, Joe.
He underwent three emergency operations in six days. He was intubated, extubated and re-intubated. He needed CPR. He was poked and prodded with needles. He had support for almost every system in his body.
When my dad died from multiple organ failure, a side effect of an initial cause his doctors never uncovered, it felt as if the rollercoaster had stopped, and I was dangling helplessly upside down.
My dad’s time in the ICU was my first intimate encounter with our healthcare system – which is a privilege to say. But in those few short weeks, I learnt lessons that will hold me through my next inevitable exchange.
I learnt that when the news is good, you’ll be told at the bedside. The ICU doctors didn’t hesitate in disclosing positive changes, as when Dad stopped needing blood pressure medication or could breathe independently.
When the news is bad, a “family meeting” will be called. The first time this happened, it was under the guise of reviewing Dad’s treatment options. The second time, it was clearer those options had run out. Dad’s doctors delivered the news to us slowly, pointing to the science, and answering our often-unrealistic questions respectfully and with care. To that end, I learnt that a private and well-equipped waiting space is a small but incredibly impactful offering.
I thought I would spend day and night by Dad’s side, but most of the time I waited in the ICU reception or in the small adjoining “relatives’ room” filled with other distressed families.
When those spaces were full – and they were almost always full – my grief spilled out into the hospital’s corridors, weeping as strangers stared, as I avoided the never-ending procession of food trolleys and medical equipment.
The waiting was excruciating. Almost every time I visited, I was met with a promise that something would be no longer than 20 minutes away, only for it stretch out, often into hours. I waited for the doctors to finish their rounds. I waited for Dad to be washed or moved or for his lines to be changed. I waited as the receptionist had lunch, taking the ability to access the ward with them. On several occasions, I gave up and went home.
A second medical opinion gave Ruby more time to say goodbye to her father.
I learnt that asking for a second opinion is an important patient right. Dad’s medical team comprised doctors, surgeons, registrars, specialists, nurses and physiotherapists. In the beginning, the rotation of healthcare workers felt overwhelming, but as time went on, faces became familiar, and I established a sense of trust with those I saw most.
When he battled a nasty case of sepsis, his body struggled to support him. One ICU doctor – a woman I had not yet met – told my family bluntly that this was the end of the road. The dreaded grief began as we held each other close until the very next day when a different, familiar, doctor suggested we try dialysis. Dad woke up. That second opinion changed everything. We got more time. We got to say goodbye.
As someone with limited knowledge of healthcare, questioning the expertise of workers who fight every day to keep strangers alive felt daunting and inappropriate. I now know that asking for a second opinion is not a symbol of distrust, but rather a message of love, and something we as consumers of our health system are entitled to.
The remaining lessons are plentiful.
I learnt that focusing on Dad’s long-term trajectory was more important than getting bogged down in the daily changes.
I learnt that bedside manner means everything to a patient’s family, and some health professionals get it very wrong.
I learnt that the nurses who spoke to Dad, even when he was sedated, flooded me with comfort.
I learnt that staff are willing to waive the strict two-person ICU rule when you’re approaching the end of someone’s life.
The final lesson wasn’t new, but during those three weeks it felt as if I re-learnt the importance of kindness. As I braced myself for the rollercoaster’s big finale, I found support in the entire ICU team. In the receptionist who left her post to speak with me while I waited alone. In the nurses who slipped me snacks and asked me about Dad’s personality. In the doctors who tried everything and still apologised when he died.
Our health system isn’t perfect. It has failed, and continues to fail, us and those we love most in the world. There are clear systemic issues we need to address and lessons that need to be prioritised by those in power. But there are small differences that can be made to make the rollercoaster run a little smoother.
Ruby Kraner-Tucci is a Melbourne-based writer and journalist.
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