What a week! I'm glad it's over, except tomorrow I start a 24 hour call.

So I started this new rotation in the transplant ICU, which consists mostly of people in liver failure. I got this one patient on Tuesday who had been in the hospital for 5 days from undiagnosed but end stage liver failure. He took a turn for the worse and came to the ICU. His story was really odd. Last week he actually went to work and was "fine". He was highly educated and had a nice white collar type job. The next day his wife thought he was acting weird so she took him to the ER. I don't know how they failed to notice he was bright yellow and had spider angiomas all over his chest, but they didn't know he had liver failure. He just got worse and worse during his stay, got infected with staph, developed sepsis, then got pneumonia and it was all downhill from there. He was ineligible for a liver transplant because he is an active alcoholic. When I came in this morning he was completely unresponsive, his blood pressure was 70/30 and that was with 4 blood pressure IV's continuously flowing. His hands and feet were cold, and his pupils were barely responsive. He was dead for all practical purposes. His wife came in later in the morning and signed the paperwork to remove care. She asked the 3 of us if we would do the same if it was our family member and we emphatically nodded our heads. We decided to leave the ventilator on but we removed all of his IV meds that were keeping his blood pressure up. He died in 10 minutes. I'm so new at this and it's really weird to think that last week he was "fine" and going to work and now he's dead. I felt so weird all day about it. I see dead people quite a bit, but this was the first that I was acutally involved in the care that turned out to be futile. I feel the worst for his wife and their 14 year old son. Maybe they had made big Christmas plans this year, or maybe the family was going to get tickets to a big game next month. Not now.