My Struggle with Intensive Care Psychosis

ICU psychosis what it's like
Intensive care units are in the news lately. Here's a story about a common experience there.
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My Struggle with Intensive Care Psychosis

When I look back at my four-and-a-half-month stay in an intensive care unit, it’s the psychosis I remember most. It’s called intensive care psychosis and it’s more common than you think. It’s often terrifying for patients and their families.

When I woke up, still intubated, after spending 6 weeks in a medically induced coma, I had delusions, hallucinations, anxiety, and paranoia that lasted for weeks. I’d had an emergency surgery, sepsis, and a series of infections but it took me some time understand that.

I was lucky to have my family there to comfort me. Their continual reassurance helped to keep me from complete panic during this period.

Here are some of the delusions I remember.

I’m in Paris, it’s beautiful here.  It must be spring, bright yellow tulips growing in the park. I’m right by that famous river that flows through the city.  I forget the name of the river, but I know it’s famous.  I’m sitting in one of those sidewalk cafes drinking in the sights and feeling the wonder of it.  I’m not sure how I got here.

 I’m about to order a coffee when I notice I don’t have anything with me.  No money, no ID, nothing.  I panic a bit. Then I need to go to the bathroom, but when I get up and move around, I can’t find restrooms except the ones you have to put money in.  The little French I took in college is all gone, I can’t find any help.

I wander into a nearby hospital still looking for a public restroom.  The hallways are lonely and scary, but I keep going.  All the patient’s doors are closed but that hospital smell of antiseptics, drugs, and patient’s shit let me know that there are people here.  There’s nothing in the halls but a few IV stands and carts of electronic devices.  I’m getting desperate for that restroom but I’m afraid to open any of the doors to ask.  I take the elevator up to the 5th floor and start looking there.

Two big men come out of one of the doors and I turn around to look at them.  They’re dressed in dark clothes. I think they are hospital employees, but they look more like thugs.  They follow me.  When I step up my pace, they do too.  When I start running, they run. 

I’m running as fast as I can, but I can’t outrun them.  They catch me at the end of the hall right in front of a huge window. 

One man grabs my arms, the other grabs my feet and they start swinging me.   I know I’m going to go out that window.  I feel the impact and the glass breaking around me.  I can feel the air rushing up and my clothes flutter around me as I fall.  When I hit ground, the wind is knocked out of me and I can’t move anything.  I look around this dark dead end of a brick alley.  There are shards of glass and broken bricks and remnants of drunken parties around me. I pass out.

I wake up in a hospital bed, there are all kinds of tubes coming out of me and my arms are tied down.  My daughter, MaiLynn and sister, Kathy are there.  They’re looking at me expectantly.

“What are you doing in Paris?” I ask them. 

They look confused.  A nurse comes in and adjusts one of my tubes and hangs a bag of liquids.  She smiles and says hello while she works. 

“They’re all trying to kill me.  I’d leave but my legs are broken from the fall.”  I whisper when she leaves. 

“No” they say. 

“Mom, you’re in Reno. MaiLynn says. You’re safe here.”

“You were never in Paris. You had surgery for your hiatal hernia. We’ve told you that many times,” Kathy adds.

“No one is trying to hurt you; they’re all doing all they can to help you.”

“O.K.” I say.  But I stay vigilant.

I doubt the truth.

This is the strangest hospital. The people act all friendly but I’m still afraid of one of the nurses and an EMT that hangs out around here. I think they’re the ones that threw me out the window. I know that everyone says that never happened.

When I use my rational mind, I figure that’s probably true. I know I’m not in Paris anymore. I guess I never was. But those two just send a chill down my spine.

But not all the weird things around here are scary.

Some of them are delightful. There are kittens here.  I know it’s against the rules, but I can hear them meowing at night. I’ve seen the silhouette of one of them.

Anna, one of the LPNs, found them abandoned by their mother in the courtyard garden. She has them hidden in the spaces in the bricks in the wall. I can hear them scrambling around right outside my window. Sometimes they hang out in the bathroom in my room. I can’t see them in there because I can’t get up.  Anna thinks I don’t know about them, but I’m trying to protect them too.

One of the night nurses came in last night and found one of them. When she heard the others, she tore up the room looking for them. She told Anna that she would be fired if she didn’t take them away.

I stood up for Anna. I told that nurse I would leave if she made Anna take them out. I guess they don’t want me to leave because they let the kittens stay. I’m glad they’re still here, but I wish they’d come up on the bed with me. Sometimes it takes a long time to tame wild kittens.

I want to go home.

Then the delusions got worse.

I knew I was vulnerable lying here in this bed. I can’t protect myself.

Last night a male respiratory therapist and one of the male nurses asked me if I wanted to go camping. I liked them both, so I said sure.  I’d do anything to get out of here.

They took me on a stretcher to a base camp at the bottom of Galena Creek campground.

A few men took me higher up the trail and took turns raping me. I screamed, but I couldn’t move or fight because my muscles have atrophied. I can’t even walk.

This morning I’m back in the hospital like nothing happened. I’m hooked up to my machines again. I just want to cry, so much goes on around here that no one sees.

My husband comes in and I whisper the story to him. He gives me the most pitying look.

“No Suzi, you’ve been right here all the time.”

He points out that they couldn’t have done this. Someone would have seen them take me. There wouldn’t have been time to get to a campground. He keeps giving me more and more evidence that this didn’t happen. Slowly I begin to realize he’s right. It’s just another of my crazy hallucinations.

I know I’m hallucinating a lot of the time.

The problem is that I don’t know what’s real and what isn’t. I always need someone to help me sort it out and give me evidence.

Sometimes I believe the evidence while my confidants are still there, but the doubt often returns when they leave. Sometimes I need to keep reassuring myself, going over the evidence again and again in my mind.

My family tells me that these hallucinations are normal.

They call it intensive care psychosis or something like that. It has to do with the drugs and the four walls closing in.  But I see their faces when I tell them about some of the things that are happening to me, or that I think are happening to me. They look worried that I am going crazy for good.

Looking back.

I think the content of the most terrifying delusions came from a feeling of helplessness and complete vulnerability. I knew I couldn’t walk, could barely move I was so weak. It must be the fault of the staff. I was regularly bathed naked by people I didn’t even know. I think that’s where the rape hallucination came from.

The hallucinations and delusions lessened over time. By the time I left the ICU months later, they were completely gone.

Everyone was deeply concerned about me during this ordeal.  My family did a lot of research on this while I was going through it. They learned that ICU Psychosis is usually situational and hoped for the best.

Through it all, they kept calm while in my presence. Patiently pointing out the difference between my delusions and reality. For that I am eternally grateful.




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