One patient in every three who spends more than five days in an ICU experiences some form of psychotic reaction. I didn’t wait that long. In fact, I didn’t wait at all.

I was admitted to the ICU unit of a local hospital late last year after suffering for about a month with what started out as a mild case of pneumonia. It got worse. I was coughing my lungs out. My eventual prognosis: Acute hypoxemic respiratory failure; pleural effusion; pneumonia; sepsis. Hypoxemic means deficient oxygenation of the blood. Sepsis is an infection, possibly fatal, of the blood or body tissues.

Terrifying

My psychotic condition may have been exacerbated by the morphine they gave me for pain. Less common side effects of the painkiller include anxiety, confusion, delusions, and hallucinations. I had them all. I was out of it for at least a week during my 14-day stay. It was, in a word, terrifying. It was, in a sentence, the most terrifying incident of my life.

Serious psychiatric symptoms

ICU psychosis is a condition in which Patients in an intensive care unit experience a cluster of serious psychiatric symptoms. It is a form of delirium or acute brain failure. Seniors and those heavily sedated are more susceptible. I was both. Among its causes:

  • Sensory Deprivation: A patient being put in a room that often has no windows, and is away from family, friends, and all that is familiar and comforting.
  • Sleep disturbance and deprivation: The constant disturbance and noise with the hospital staff coming at all hours to check vital signs, give medications, etc.
  • Continuous light levels: Continuous disruption of the normal biorhythms with lights on continually (no reference to day or night). •
  • Stress: Patients in an ICU frequently feel the almost total loss of control over their life.
  • Lack of orientation: A patient's loss of time and date.
  • Medical monitoring: The continuous monitoring of the patient's vital signs and the noise monitoring devices produce can be disturbing and create sensory overload.

Had to be restrained

During at least two of the more violent incidents, I had to be restrained.

I kicked a male nurse in the head. It’s scarier than any nightmare because the characters with whom you’re confronted are real. They were trying to help me, of course, but my paranoid brain insisted they were out to get me: They were slithering black and blue serpents with human heads (their outfits were black and royal blue), grabbing at my feet and hands and head and yelling at me.

One psychotic incident began with me feeling as if I was being dumped from the ceiling into a room of these vile creatures, knowing what was about to happen and that I couldn’t stop it; knowing that it wasn’t real but no less scary. "Oh no," not again," I thought. I’ve had some limited experience with hallucinogens during my more than middle-aged life.

None came close to the psychotic horrors my addled brain pummeled me from inside that ICU room. The hospital staff called my wife Adrienne to try to calm me down. She was like this hazy cloud of sanity and calm at my side. At one point a nurse concluded I was suffering from alcohol withdrawal. This cavalier diagnosis angered my younger daughter Elizabeth. Given our family's regular but moderate drinking habits, she vociferously criticized the shoot-from-the-hip diagnosis.

Off-the-books operation

I don’t know what really happened to me that first week and what I imagined. There was a time when I thought they had moved my entire hospital room to my house to avoid prying eyes. It was as if I was in different rooms at different times, but I never moved from that ICU room until later in my second week when my condition improved.

At one point I thought I had agreed to participate in some secret off-the-books operation, a co-conspirator with the hospital serpents. In my mind I went through the operation, lying on my side on an operating table while a doctor pounded on my spine with a hammer and chisel.

After my real surgery, to remove muck from the center lobe of my right lung, I came out of the anesthesia a little early, as they were wheeling me out of the operating room. I immediately thought I was back in psychotic hell. I ripped the intubation tube out of my throat, something I’m told is no easy task, and hurled it across the room. Gratefully, I came to my non-psychotic senses before injuring anyone else.

Treatment options

Sleep, antipsychotic drugs, frequent family visits, and getting out of the ICU are among treatment options. I’m not sure how I found my way out of my own hallucinogenic horrors. I just remember waking up without them. My older daughter Megan actually diagnosed my condition before it was confirmed by hospital staff. After posting an account of it on Facebook and talking to friends and family about the ordeal, I was surprised at how many knew about the condition, went through it themselves, or had a family member suffer its devious delusions. As I mentioned previously, experts suggest it happens to a third of all ICU patients.

I'm better now. Just this week I finished three weeks of horse-pill-sized antibiotics.

Tuesday I go for what I hope to be my last CAT scan. At least one thing positive occurred during my ordeal: I lost 16 pounds, although I don't recommend it as a practical weight loss regimen. Stick to Nutrisystem or The South Beach Diet.
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