The Q Word

Tuesday 26th May 2020

Figures for 25th May

UK COVID Deaths 121 / Total 36,914

James Cook Hospital – Total COVID deaths – 223

All COVID cases within South Tees Hospitals Trust – 41

James Cook Critical Care COVID cases – 8 / 6 ventilated

James Cook Critical Care non-COVID cases – 33 / 10 ventilated

Nicky has been on-call for emergency admissions, but has stopped by the COVID Intensive Care Unit for an update because she knows I will pester her when she gets home for information on each and every patient.

I wrote last night about how nearly all of the patients had been making progress in the right direction. This has continued today, such that a couple of the patients have had their breathing tubes removed. There is always a chance that they will be unable to manage without them and they will need to be re-intubated but the fact that they have got to this point is a good sign.

Outside the ICU, Nicky hasn’t had too busy a day. There have been a few patients that required her attention but we have not admitted any COVID patients today. In fact, it was suitably calm that Nicky managed to find the time to get some lunch which is unusual for her. Despite us doing the same job within the same department she often seems to be far busier than I am.

Now part of this is because she is more conscientious than I am. She is much more of a t-crosser and an i-dotter than I am but this doesn’t really explain why, when she’s on-call ‘stuff happens’.

If you visit any Intensive Care Unit around the country you will find amongst any group of Consultants, one or two who could readily be described as ‘cursed’. Their shifts will be horribly busy, with the sickest patients turning up in A&E, existing ICU patients becoming poorly and endless telephone calls from the wards informing them of patients who need review. They will run out of beds and have to ventilate patients temporarily down in the A&E department, they will be beset by nursing staff shortages or equipment failures and then, once their shift is over, they will be unable to leave the hospital because a road traffic accident has blocked the road outside the hospital.

Our department has three or four such Consultants. Common sense would dictate that such occurrences are all down to chance and co-incidence but after over twenty years of working with them, even I now think there’s something to it.

Of course, there is an argument that we all make our own luck and much has been written about the science of what we choose to call ‘luck’. I will often joke with non-medical friends that the only thing better than a good doctor is a lucky doctor. Everyone laughs but there’s probably something in this, at least when it comes to the emergency specialities.

Now, it goes without saying that if you believe in good luck then the corollary is that you must also believe in bad luck. The most consistent example of this is the universal avoidance of the ‘Q-Word’ in hospitals. It has become such a totem amongst medical and nursing staff that no-one dare mentions the word ‘quiet’ at any time. It’s a bit like uttering the ‘Scottish Play’ amongst a group of theatre luvvies. Should you do so then it is akin to standing on the top of a mountain, in a frenzied lightning storm, pointing a huge sword skywards and challenging The Almighty to strike you down.

Of course, I know that this is all rubbish but I must admit to feeling slightly uncomfortable even writing about it. Such traditions run deep and even I don’t fancy upsetting the Gods of the Intensive Care Unit right now.