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as well. Her view from inside to outside must have solidified
the feeling: healthy people laughing, interacting, going home
to family and friends.
Tammy's response was to be severely withdrawn. emotionally
shutdown.
When I was assigned to her, I tried to connect with her,
but could not get any traction. I was nervous as a new trainee,
and my goal really was not to screw up her medical treatment
plan. But recognizing her depression, I did consult child
psychiatry to help her during this time. I stopped by her bedside
multiple times throughout the day to chat, specifically
avoiding medical jargon. During the first few weeks, I ended
up mostly speaking to her mother, as she stayed withdrawn.
After some time, through subtle probing, I discovered one of
her favorite TV shows was "Fear Factor" — a reality based
TV show that puts contestants through extreme challenges. I
started watching the show so that we had something in common
to talk about.
I had the idea to bring "Fear Factor" to the Cardiac ICU.
After convincing several of my colleagues, nurses and
even the ICU attending to participate, we set up daily challenges
for the medical staff to go through, very much in a
Fear Factor manner. Wheelchair races, who-would-toleratethe-biggest-IV-needle,
etc. I could tell Tammy was instantly
interested. She looked forward to the next challenges. My
challenges for her were mostly physical (as a secret agenda
to get her rehabilitated: transplant recipients do far better
when they are better conditioned). Her interest grew, and she
started coming up with challenges of her own. "Put an nG
tube in your nose!" (she had one), "Drink the nasty Colace!"
(she had to, too). Her mother commented to me that for the
first time in a long time, she's smiling.
It was a fateful Saturday morning, when I came in for my
call, I found both Tammy and her mother sporting an evil
grin. They had procured a cockroach to ingest as the next
challenge. everyone instantly refused to partake in this one.
So did I. Towards the afternoon, it looked like this challenge
was going to be a bust. Tammy was by nature a stoic girl,
but I could tell she was more than disappointed. Fearing we
would lose the momentum of her new found spirit for life, I
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