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Recently, I spent a few days being completely cared for. I was allowed to do nothing for myself. Forced to lay in an uncomfortable bed, unable to get out being tied in via neck and arms to machines and tubes, with more tubes coming out of my body. And all the time I was intensely aware of every single passing second. Every beep and gurgle, ever waft of air and alarms, oh the alarms.
My senses were hyper alert in an environment that had simply too many parts clamouring for attention.
Yes, I was in a hospital. At least this time, it had been a choice.
Now, I don't tell you this to garner your sympathies. All that should matter to anyone is that I am now out and recovering very well thank you.
No, it's because I relearned some incredibly basic ideas about leading ourselves and leading others. Why we hate to be trapped in a bed or any environment and how our stress is made extreme by the more basic and fundamental (perceived) threats to our life.
My experience this past week in the hospital will be little different to anyone in intensive care or high dependency. You have just emerged from a traumatic experience. Shock is the most useful term here. Shock to have come through, shock that things worked well, didn't work so well and shock at the discovery of each new tether to the bed.
With each tube, you have lost a little more personal control.
And then there are the monitors. Those glorious machines who flash and hum and beep and shriek. And of course, your readings are above and behind you. Out eye line. Noise emerges and you have no clue what it means. It just sounds alarming. You try to look around and make no sense of anything except red or yellow flashing lights.
All you can see are the machines of others in the room. Of course, if you are in a private room you may have the benefit of less clamour, but then you won't have much company either. Seeing others are like you makes it just a little more tolerable.
The gentleman opposite spent the night going through a traumatic and frightening instability at exactly the same time as I did. I can hear my alarms, feel my heart thumping, fluttering and pounding whilst watching his very very frightening numbers and his wretched face peering back at mine in the terror of the moment.
The nursing staff, whilst not completely blase, really behave as if this were perfectly normal. Which for them, it is.
They see this day after day after day. I am seeing it for the first time. There's me looking at a guy who's heart might explode in front of me, and honestly, I had no clue that your heart could clock that sort of rate and pressure and not explode.
I'm not just not asleep, I am so awake that every fibre of my being is screaming at me. The nurses tell me that it is better to allow myself to become less sensitive, less worried. That my own stress is making it far worse. Of course, I know that this is true. That I am also in the middle of a panic attack, let alone atrial fibrillation, but I cannot turn off any of my alertness. Oh the blessed relief of sleep, but it never comes.
I finally dropped back into sinus rhythm at 8.30 the next morning.
The choice of drugs had, at last, done their job and I knew that recovery was somewhat more certain and a glimmer of hope began to emerge. I might actually make it out of here.
Those of you who have been where I was, know exactly what I'm talking about. As I learned from my fellow inmates, whilst some are more sanguine having been through it before, the feelings and responses are essentially the same.
You can tell on the faces of those who have just one single tube removed. Prior to this, they were as miserable and sickly as everyone else, and suddenly their whole countenance lifts. Immediately they look better. And, so long as it was a good decision to remove that tube, they remain a tiny bit more hopeful. Each tube is a victory of self-control.One tiny element where your mind begins to believe that there will come a day soon when you will once again be able to control when and how you go to the toilet.
Yes, the pooh in the title was pooh and not the Winnie version.
When it comes down to the feeling of being in control, there is little more dignity lost than when you cannot pass motion yourself. In private. Comfortably, in private. Cleaning yourself up and emerging refreshed, renewed and ready for another day.
the parts of the body are bored one day and get into a discussion about who is the most important. the limbs each make their argument, then the major organs, the brain, heart, lungs, liver, etc…all make good arguments (although no one pays attention to the appendix or the spleen)…as they discuss this, the anus claims to be the most important…they all laugh, so it says ‘OK. I will stop working, and see how you do'…after a few days, all the other body parts agree that the anus is, in fact, the most important part of the body…by far. (Thanks to Clive for that reminder :-))
Peeing, or passing urine as they insist on calling it is less undignifying (at least for guys). And compared to using a catheter is an enormous leap forward in being in control.
On day 5 I was finally allowed to sit up out of bed on a chair.
A lot of commotion and moving containers and tubing but the bliss of being able to sit and not lie. Briefly standing between. And I took this new found freedom to realise a much-needed release. I swallowed the last tiny little shred of my dignity and finally admitted that I was not in control of anything in my life now. That I was totally in the hands of professional staff and asked for a commode. After several attempts and with some suitable medical enticements, eventually the task accomplished and I chalked up another victory on my walk back to self-efficacy.
And it caused me to reflect on organisational life.
How often my clients complain that they are constrained and held back. Their bosses scared to lose any control, micro-managing every decision. Some get broken by the system, surrender to the inevitable and lead miserable, unfulfilled lives from paycheque to paycheque.
Others, break free one tether at a time and their faces are filled with hope and possibility. Sure it gets frustrating because there's always one last tether still in place, but that feeling of having some control over your own life and destiny is a powerful motivational force.
It is hardly surprising that prisons use the strategies to take away self-efficacy in order to break the will and ensure compliance. But why do organisations and their leaders feel that they should adopt similar practices?
If you want a group of compliant workers doing just what they're told, no more and no less, then, by all means, tie them to their metaphysical beds, rig them up to monitoring devices and remove as much of their human dignity as possible. Keep it up for long enough, and they will forget how to be independent and accept whatever you tell them to be true, is of course, true.
Within an hour another two tubes were removed and the promise of G Ward held out for the morrow. Which was of course “hospital time” for a “couple of days”.
On my last day in HDU, I was freed from another tube and monitor and even managed to eat something of the porridge that someone insisted on ordering for me. I don't recall, at any time, actually requesting rice porridge and can't ever imagine that I would. Others who would willingly have consumed this were forced to down stuff that I was beginning to hanker for. A slice of bread.
Not that my appetite was all that great, it was coming back in line with the more I felt that I was in control. That I now held the possibility of making a decision and choosing to follow it through for myself. Not to have to await someone else, however professional they may be, I just wanted to do something for myself.
I needed to take back control of my life.
Once free of tethers I was allowed to shower. I had, so far. avoided contact with mirrors but now I stared at my reflection and decided that I looked way too beaten up and sickly and that a shave was in order. Not easy with a central line still plugged into my neck but at least I could begin to look a little better. Feel a little fresher and clean the remnants of what smelled like a dead rat from my mouth.
Slowly but surely, with each recovered aspect of self-efficacy, I began to feel happier, more hopeful and better.
The next step in progress is to re-learn how to walk and start re-building strength. Bearing in mind that from the second day, we've been re-learning how to breathe and cough. With assurances that practice and dedication will bring the fastest return, the physiotherapists help me get to a point where I can walk unaided around the ward.
This is now the most dangerous and risky time. The operating theatre and ICU/HDU are controlled environments. Or at least more so than the General ward. Now is the time to be most watchful of complications. A tiny microbe can set you back weeks or months. So regaining your strength and cleanliness is essential and pray for protection.
Choosing to take charge of your recovery from a setback is critical to that recovery.
There were a few in the ward who, whilst capable of walking and rebuilding their strength, were either too scared to do so, or simply unmotivated. Sitting on their beds waiting for someone else to cajole them into exercise. Some remain for months and essentially give up their independence and allow others to take care of them from now until whenever. They made it beyond forced compliance and yet hankered for it.
Those who do get up and walk, rebuild strength, recover faster and leave sooner.
And just as in the organisational ranks, there are those who have “get up and go” and those who leave it to everyone else to make decisions and move things along. It's a choice we make, and I know which side I would rather be on.
There are those few, those precious few, who desperately want to take charge but with one complication after another, are forced to stay behind for longer. And the longer they stay, it seems the more likely another complication will arise. After all, you are surrounded by some very sick people. A simple cold could set you back weeks.
Their power to recover has been stolen from them, for a time, by a microbe or a virus.
Those who continue to have hope and that drive for self-efficacy will beat it and emerge victoriously. Others succumb and are weakened physically and their drive and hope take a knock and they need someone to reignite that hope and work that drive until they have enough strength of their own again.
Be watchful of your friends and colleagues who get weakened by the system. Don't always assume that it's only about choice, there are things going on in everyone's life where they have little or no control and it robs them of their strength, their hope and their drive. Be a friend and lend them your help, your hope and your drive to allow them to choose again to take control back.
It is my hope that you have found this a useful podcast. If you know anyone at your work who looks like they've had their feeling of being in control stolen, perhaps it is time for you to reach out and offer your non-judgmental love and attention.
If you know someone who is about to, or considering a CABG (heart bypass) or any other heart surgery and they would like to talk, please do put them in direct touch with me.
Thank you for your love and prayers.