I Know You, I Know You Not

Anna Burkhead -- It was only my second day on the rotation when you were admitted after your tanker jack-knifed on the highway and you sustained 35% total body surface area burn from the gas explosion that followed.

I watched as my attending used the Bovie to perform escharotomy on both of your arms. I calculated your resuscitation fluids using the Parkland formula.

I learned how to do my first central line on you. I also did my 4th, 9th, 14th, and 20th central line on you. I’m sorry for all the pressure and needle pokes. Sometimes I could tell from your heart rate that you were in pain. I explained to you the need for frequent changing and rotation of central access in burn patients; I hope you understood.

I watched as the chief resident and attending trached you. You don’t have a lot of neck, and it looked hard.

When you were stable enough to go to the operating room, I put all 100 lbs of my body weight into holding up the hip of your 400 lb frame. It was a long operation. Your back was a massive area to cover with skin grafts.

When the graft on the back of your head sheared off because of your C-collar, I called Neurosurgery to talk about how we could clear your spine. You are too big to fit in an MRI machine. You weren’t responsive enough for flex/ex films. We didn’t have many other options, and the C-collar stayed.

I examined you in the most intimate of places when you developed a complication related to all your swelling.

Every morning I reported your ventilator settings, blood gas, and labs to my attending. Sometimes he asked questions about what to do about this lab value or that blood gas. Sometimes I got the questions wrong. Don’t worry, there was always someone overseeing me in your care. Sometimes patients don’t like medical students caring for them. I don’t think you are one of those people.

I talked to your brother every afternoon and updated him on your progress. I got so used to seeing him in the yellow burn contact precautions gown and gloves that I didn’t even recognize him in the cafeteria one day.

I followed you as a patient for the entire month that I spent in the Burn ICU. I talked to you every day, although you didn’t respond. Eventually you kept your eyes open and moved your arms a little bit. During rounds on my last day in the ICU, we decided to start weaning your sedation. I hope you wake up soon. I would like to meet you.