Tiny winged angel of death
Theres an old saying in ancient nursing lore that if a fly lands on a patient in the ICU, that patient will die within 24 hours. One of the more wizened nurses here swears by this. She says that every time she has seen a fly - and how often do flies get into the incredibly atmospherically controlled and conditioned ICU? - a patient has died. It is a horrible omen.
On saturday morning when I got here to round, sadly, one of my patients had died. I did a cartoon-esque double take as I walked passed his room, and then stopped and backed up. There was a slight delay before I registered that the monitor was off, the room was silent, the curtains were drawn, and he no longer had a breathing tube in. He was lying there, cold, still, dead. God damn it, I said out loud. He had died about an hour previously.
A fly had landed on him the day before, smack dab in the middle of his forehead.
This makes me think that either the fly has some sort of heightened sense of smell that is so sensitive to rotting flesh that it can detect biochemical changes in human skin and secretions that indicate impending organ failure before our own medical tests detect anything. Either that or each fly in the ICU is actually a tiny winged angel of death that has taken on insect form to deliver its grim news to future victims by gently landing on their foreheads, kissing them with many soft, beconning, feathery feet.
Then again... later that same day I saw a fly on another one of my patients. And she did not die that day. In fact, she is extubated now, looks much better, and is being discharged from the ICU. I think perhaps instead of it being an omen of impending doom, the presence of a fly in the intensive care unit is simpy a sign of a gap in the ventilation system.
I never heard about the fly thingy before. I think would do well to at least kind of listen to even the crazier sounding folklore of nurses. There's usually a (good?) reason for them.
Yeah, I will be lucky if I ever know half as much as an ICU nurse. And I think there probably is something to the "nurse's intuition," whether or not every omen is a personal sign from the grim reaper himself.
I'd believe that insects who rely on finding decomposing flesh to lay eggs in, for the survival of their species, might well be more acutely aware of odour-changes than we are. And yet, in other traditions of medicine, and in earlier times, some illnesses can/could be diagnosed by smell.
Wizened nurses, now that's scary!
There is some evidence that dogs can detect cancers in people based on the odors such persons emit:
http://news.nationalgeographic.com/news/2006/01/0112_060112_dog_cancer.html
That's awesome. I also have seen previous studies of dogs being able to detect cancer in urine (though I think the sensitivity and specificity of such testing is far from being at a reliably diagnostic level). Wouldn't it be cool if instead of getting a CT scan or an MRI you were just put in a room full of dogs who sniffed you all over? I would go to that hospital.
....when i see bugs, flys, and such in the icu and other places in the huge hospital i work at. Im always thinking...i had to walk miles to get here from out side air and how did this stupid bug get in here it annoys me. It didnt have to pay for parking either. I never heard that about the omen thing though
You really have a talent for writing. Your blogs are very entertaining. You should think about being a part-time freelance writer. Keep Postin!
I'm sure MANY people have told you how inspirational your writing is, and I'd like to join the masses. In fact, were this a book sitting on that tiny medical shelf in Barnes and Noble, I would most definitely shell out 25 dollars just to read it in the comfort of my own house.
hi,fiona
I am a medical student in China.
Your writing is full of inspiraton.
I do hope that I can read what you write often.
This is pretty crazy... I wonder if it holds true for ER as well. Today I saw a fly land on a patient who wasn't doing too well and whose family had put on a DNR and I thought of you.