My first day as an anaesthetist, after the 1969 flu epidemic, I was sent to a patient having difficulty breathing. 'Just go up and let us know what you find.'
A female apneic, hand-ventilated by the sister, a veteran of the Queen Alexandra's Imperial Military Nursing Service from the Second World War. She told me to b***** off and find a real anaesthetist.
I was set to watch over this poor soul, intubated and tracheotomised, connected to a ventilator the size of a car. I was there, off and on, for the best part of a month, until she showed some signs of recovery. She left in a wheelchair two months later. I marked acute Guillain-Barré syndrome as something better not to get.
One day in 1994 I was driving home when I noticed tingling in my hands and feet. By early evening it was difficult to stand up, and touching things felt like gripping barbed wire, the symptoms were in a perfect glove and stocking distribution. No need to bother the GP; no neurology at the local DGH, so I got my wife to drive me to my own hospital and arrived in A&E and called the physician, who was thrilled to hear that the Director of Anaesthesia had acute GBS.
Within hours I had the mobility of Flipper and a strange buzzing sensation in my chest as various intercostal nerves fell out of use. In two days I only had my diaphragm and throat muscles and was scared by the discussion round the bed to choose which type of tracheostomy. They wanted to cart me off to the university where I feared I would be just another GBS. If I stayed, I knew it would be very bad form to lose the boss.
They wanted to cart me off to the university where I feared I would be just another GBS.Douglas Newton, retired Clinical Director of Anaesthesia
Then a miracle occurred: they had already been filling me with gamma-globulin because I presented early with the diagnosis. Respiratory function started to improve, and by the end of the week I could flop my arms about though without proprioception.
I was in the rehab unit for the next two weeks, and felt so sorry for the other patients who strove so hard after their strokes, whereas I was carried in at the beginning of the fortnight, and walked out with a stick at the end.
Few ITU consultants have had a crash course in being a totally helpless patient, and come out of it completely well. I knew that GBS had a significant morbidity and mortality: this concentrates the mind and has had a lasting effect on my attitude to patients, relatives, and my colleagues: empathy and gratitude. I found, when swinging helpless and naked on a hoist, embarrassment is an unnecessary luxury.
Strangely, although I wanted to help with the GBS society, I feel fraudulent having recovered so completely that it would be cruel to parade before patients who are permanently disabled.
For the last 17 years of my career this single episode has contributed more to my understanding of the personal side of critical care than any other experience.