HOSPITALS WILL KILL YOU, PART I
ICU Psychosis: I never heard the term until my Dad was throwing hammers at bad guys after his hip surgery. But it’s real. Being critically ill can mess with your mind.
These days it’s called ICU delirium, in recognition of its medical basis. Even so, it’s not at all clear why being in an ICU drives people crazy. Folk wisdom had it that having the lights on all the time and being awakened every 2 hours for meds or tests would send anyone around the bend. But that’s not quite the case.
Something is unhinging these patients, though. In fact, the majority of people who spend a few days in the ICU will go nuts: They’ll have hallucinations and paranoid delusions, and may not recognize family or know where they are. They often have to be tied down. I arrived at Dad’s room one morning to him cheerfully relating how the morphine gave him hallucinations of being attacked in a hardware store. He had lurched from his bed, complete with oxygen mask, wires, tubes and a newly implanted hip joint, and thrown hospital gizmos around the room in self defense. It’s a real, true brain disorder.
And it’s serious. People who experience it are statistically cursed: They’re much more likely to have a long stay, and to die in the next few months. But is that cause, or effect? Maybe only really, really sick people get ICU delirium.
That’s kind of what studies indicate. A history of alcoholism, smoking, and thinking impairment adds to your risk of ICU delirium. People with a head trauma are strong candidates. But even if you enter the ICU with a clean, healthy brain, you won’t maintain that status long: You’re going to get opiate meds pretty quickly, and those, too, look like they contribute. Furthermore, many ICU patients have trouble breathing, which lowers their circulating oxygen, which starves their brain.
The emerging picture is that it’s not the lights and the noise that bend your antenna in the ICU. It’s that you’re ill enough to sicken your brain — if not by with original illness, then with the falling oxygen and the rising opiates.
The prognosis even sucks: If you get ICU Delirium and live to tell the tale, you may not tell it as clearly as before. The effects of brain sickness can linger for years.
