Once upon a time, there was a patient, who, for the last one month, had been on a breathing machine because no one could figure out what was wrong with her. Or how to fix her. For the last one month, every doctor in the unit, all the top brass had been scratching their head thinking “what the bloody hell is going on?” They tried every trick in the book. Making the patient lie upside down. Inhaled nitric oxide. Fancy modes of ventilation. None of the tricks worked. Some made things worse.

Then came this man who walked into the ICU one day. He was a very simple, unassuming man. He stood and watched the patient for a while. Watched the breathing machine do what it was doing. Looked at all the blood tests. Then, almost as if he was thinking out loud, he started talking. Went to the breathing machine, and played with the settings. Almost immediately, the patient’s breathing improved dramatically. Two hours later, her blood tests looked better than they had ever looked in the last one month.

This man did what everybody in the last one month was trying to do, but nobody actually managed to do it. And the beauty of it was, when he actually explained what he did, it was so bloody simple. Its what should have been done right at the start, but no one thought of it because it was so simple. Nobody tries simple things with a complicated patient. Yet that is exactly what was needed.

Sometimes, it takes a real genius to focus on the problem without getting distracted by all the superfluous details along the way. A la Arjun. I really wish I had this clarity of vision in my repertoire. What this man did today blew everyone away. There is now hope for this patient. Hope that she will survive. Make it out of the ICU someday. See her grandchildren grow up one day.

You know, I never really understood why people liked working in the ICU. Its a hard lifestyle. You get called at 3 AM. You miss your kids’ birthdays and school performances. Your stress levels are perenially high, because all your patients are bloody sick. But today, I had a glimpse of why ICU is such a rewarding career. And it took my breath away…..