Mr. G

Mr. G arrived on the Neuro ICU early Thursday morning.  A man who had barely crossed the threshold into middle age, he suffered from relapsed refractory leukemia.  The cancer had left him with few functioning blood cells, causing him to develop an intracranial hemorrhage.  The resident loaded him up with bag after bag of FFP and platelets, to no avail - his INR, at 1.7, would not budge.  Finally, she pulled the "big gun" and ordered Profile 9, a specialized blood product used as a last resort in coagulopathies.  The resident jokingly pointed out that with one click of a mouse, she had spent her entire year's salary on this patient.  (Profile 9 is apparently extraordinarily expensive.)  But the cancer had put its foot down, and his INR went up to 1.8.  The bleeding, however, was only one of his many problems.  Overnight, he had spiked fevers as high as 105 and no amount of antipyretics, chilling blankets, and even cold saline would touch his fever.

Mr. G's room was located directly across from the Neuro ICU resident "nook," where we sat to type notes,  examine images, and check lab results.  Even from 20 feet away, I could see that he was miserable.  Shivering and delirious, he managed to nod when we asked if he was nauseous.  His wife visited daily, and I learned that he had a young school-age daughter.  Over the next few days, I watched him slip further away and become less and less responsive.  Eventually, he was transferred to the oncology floor, where he died the next day.  In my short two weeks in the Neuro ICU, I would see 3 others on the floor pass away, but none that were as excruciating to witness as Mr. G.  I hope his family finds peace.