NSU and beyond

When you start dreaming about work; does it mean that you actually have your dream-job? The last two weeks have been not just amazing but very inspiring. The long hours didn't matter, the lack of sleep didn't matter but every time my head hit the pillow I felt happy and content that I'd given it my best. Neuro-critical care is such a young field and full of hope. There's a lot of work which needs to be done but we're moving along.
I love the pace in the NSU. I love the procedures-the lines, the tubes, the monitors, the ventilators; the physiology...because somewhere beyond all that machinery life lives;sometimes snatching the last breath from death's hands and sometimes just waiting patiently for the right time to bounce back. Stuff happens. Both good and bad. Somebody symptomatic from their VBI undergoes an angioplasty and stops vomiting every time they sit up; somebody with a ruptured aneurysm undergoes clipping and responds to your voice and moves their hands and legs; someone with a SDH wakes up after a burr-hole; someone with status epilepticus stops seizing and wakes up to get extubated...
And then there are those who get locked in inspite of all heroic measures-ia tpa, stenting, hypothermia...and there are those with brain tumors who stroke out from tissue shifts after you tide over their septic shock heroically; there are those with SAH who keep developing vasospasm no matter how much of HHH you try...
But; the bottom line is you try and try with all your might, with all your resources, with all your heart.
The brain is not as homogeneous as the heart; so resuscitating the brain is not as elegantly simple as CPR. Before we see damage on our currently available radiologic modalities like CT/MRI, much has happened to cause both reversible and irreversible damage. We have a long way to go but we are on our way; that's what it felt like when I stepped into the NSU everyday.