The aim of this study was to illuminate the meanings of being critically
ill in a sound-intensive ICU patient room, as disclosed through
patients’ narratives. Patient rooms in ICUs are filled with loud activity
and studies have revealed sound levels comparable to those of a
busy road above the patient’s head. There is a risk that the sound or
noise is disturbing and at worst a major problem for the patient, but
there is a lack of knowledge concerning the patients’ own
experiences. Thirteen patients were asked to narrate their
experiences of the sound environment in ICU patient rooms. The
interviews were analyzed using a phenomenological- hermeneutical
method inspired by the philosophy of Ricoeur. Six themes emerged
from the analysis.
Conclusion: The meanings of being a patient in a sound- intensive
environment were interpreted as never knowing what to expect next
regarding noise, but also of being situated in the middle of an
uncontrollable barrage of noise, unable to take cover or disappear.
This condition is not to be seen as static; for some patients there is
movement and change over time. The meanings indicate that the
unpredictable shifts between silence and disturbing sounds stress the
critically ill patient and impede sleep and recovery. Our findings
indicate the need to reduce disturbing and unexpected sounds and
noise around critically ill patients in high-tech environments in order to
facilitate wellbeing, sleep and recovery. Nurses have a vital role in
developing such an environment.
Meanings of Being Critically Ill in a Sound-Intensive ICU Patient Room - A
Phenomenological Hermeneutical Study Lotta Johansson, Ingegerd Bergbom, and Berit Lindahl. [1]
I WORRY about the horror of the ICU
despite all good intentions
and the dizzying scientific advances
and gains in fighting disease and death
acute heart and lung disorders
stroke and arrhythmias
But the price,
the price
we pay,
in terms of our loss of dignity and humanity.
Watching my father in-law
after massive stroke
connected to ventilator
a silent vigil
in the presence of technological noise…
The price,
in human suffering
was not calculated
he was not consulted
yet he survived through this very Apollinic miracle
of the intellect, the mastery of science and technology.
so...
we have disconnected the tubes
and survival is now assured
with such a deficit
and knowing
how he had felt about these things
and watching his stoicism
and dogged faith
in the face of all of this
the very indignity of his exposure
the absence of privacy
every index of bodily function displayed
on monitors
to see and hear the beeps
and the sounds of breathing, pulse,
alarms bells and whistles going off
all around.
Suddenly this rhythm is disturbed by the loudspeaker blaring
sudden codes Blue, Red, or Green,
over loudspeaker for all to hear
medical staff and patients…
sudden rushing of personnel to one room
and then silence.
Not knowing what happened.
Except for those initiates in white
To whom the gnosis was handed down.
The terror and horror
is evident all around
humanity is not important
only physicality
in this temple to the body, survival
no, not even the body...(skin gets ignored)
rather, survival of vital organs the heart and lungs
a temple to the pulse and blood pressure
a church to the oxygen content of blood and the culture of
body fluids.
What happened to us?
the Apollonic analytic impulse gone awry
for the sake of mere body survival?
We sacrifice the soul
we trample over the heart
we trod over the psyche in pain.
Depression, anxiety, terror, paranoia
have no place here,
like the trenches of WWI
in the trenches of medical warfare
those feint of heart must go home
but here, to die peacefully?
it's either or…
For if you enter these rooms
you must surrender soul at the front door
and live the indignity of exposed documentation of every body index
the numbers game,
the spreads,
the cultures of bacteria,
the analysis of blood until anemic.
Then to submit to the insertion of tubes into every orifice
that force in or retract body fluids
that invade the inner spaces of bladder
lungs, gastro-intestinal tract or veins.
They measure what goes in and what goes out
they analyze and form spreadsheets and x-cel files
and then alter the program accordingly.
If, and only if, you release your body to them
might you withdraw to the mind
withdraw to the only space left you have control
the imagined body of pain:
the mind's eye, the imagination, the inner turmoil.
That is if you are not turned prodded poked or injected
Trached, intubated, pegged x rayed, scanned ultrasounded, or merely EKG’d.
Then they make rounds on you,
Those boys in white
as if you as an independent thinking person
do not exist
for what you have to say has no relevance
they have you pegged already
there is nothing you could offer
no information of any use to them.
They huddle and decide
without your consent
(you left that at the front door remember?)
as to the next course of action
in their war against the angel of death.
Of course their motive is pure
Of course they studied hard to get here
Of course they claim victory in their battles
Of course they do so with courage
They are on the hero’s quest after all.
They are on a mission
they have rules of engagement
there are commanders and generals and privates
there is rank.
There is competence and incompetence
And behind all of this is another industry of malpractice lawyers
Just waiting to pounce on them.
In this tyranny of the soul
how does one survive?
really?
What must one sacrifice
to survive?
what scars are left from just this grotesque omission?
this failure of vision,
tied down
on the altar of Apollo?
The mastery of Logos?
I think I know...it came to me….
EROS!
she is left to wither
never to re-cover,
never to rise.
She is the sacrifice to the men in white
the high priests of Apollo and Logos.
Her softness and intuition
Her mildness and round corners
Defies the hard edges of the machines
gathered around the bed of the Patriarch
With her, chasms of separation and alienation are bridged.
The Goddess is absent.
Woman’s psychology is founded on the principle of Eros, the great binder and loosener, whereas from ancient times the ruling principle ascribed to man is Logos. The concept of Eros could be expressed in modern terms as psychic relatedness, and that of Logos as objective interest.
(Jung, Aspects of the Feminine, 1982, Princeton, p65).
Logos is a certain peculiar quality in a man's being which leads him to discriminate, to reason, to judge, to divide, to understand in a particular way. And one cannot understand all this without also thinking of its antithesis, the equally intuitive concept of Eros, which would be then a principle of relatedness, seeing things together, gathering things together, establishing relations between things, not judging things, not looking at them properly, but rather attracting or repelling them. Maybe we need a medicine based on EROS not LOGOS so that we can choose, the question is what would it look like? The ancient Greek word psyche means “butterfly,” a creature that undergoes a long period of metamorphosis in the chrysalis state before awakening is possible. The maturation of the soul unfolds through the lure of Eros. The myth teaches us that without the prick of Eros, the containment of the imaginal realm he creates and experiences of erotic destruction, the psyche remains virginal and infantile. An example of a virginal psyche can often be seen in someone who is fascinated with dreams and visions but is caught in constant reflecting. Transformation begins in imagination and reflection but requires a move forward into the possibilities that have been imagined. Reflection is not enough. Psyche needs embodiment. Eros provides the impetus for this movement by bringing a passion and desire for a fuller and richer life. According to Plato, Eros doesn’t just have to do with our relationships to people, but with all interactions, both inner and outer, to nature and to spirit. Eros has to do with intentions of the Self. As individuals, we need to be willing to suffer the bitterness as well as the sweetness that Eros brings. The god’s wondrous beauty needs to be seen and known, which can only occur through our own personal suffering and sacrifice. This is not neurotic suffering, but suffering in service to the Self. Our awakening begins with our yearning to “be in touch” with each other and with our sense of how “out of touch” we are with our archetypal roots. Eros gives the soul this yearning Apollo and Daphne.
The myth of Daphne is an illustration of fate and revenge of the gods. She was part of cruel power play between two archers, Apollo and Eros. The proud Apollo bullied Eros who shot two arrows, one tipped in gold and the other in lead to find revenge. Eros, the son of Aphrodite enchanted his arrows to cause total lust and desire in the golden arrow victim, and total hatred in the recipient of the lead tipped arrow. Apollo was hit with the golden arrow, and the object of his desire, Daphne, was struck by the lead one. The struggle between lust and chastity is ended when Daphne turns into a laurel tree. She begged her father to transform her body forever in order to escape Apollo’s desire for her. Eros is a superhuman power which, like nature herself, allows itself to be conquered and exploited as though it were impotent. But triumph over nature is dearly paid for. Nature requires no explanations of principle, but asks only for tolerance and wise measure. "Eros is a mighty daemon," as the wise Diotima said to Socrates. We shall never get the better of him, or only to our own hurt. He is not the whole of our inward nature, though he is at least one of its essential aspects.
(Two Essays on Analytical Psychology, CW 7 (1957. "On the Psychology of the Unconscious” P.32f)
Eros is the god of sexual desire. He marries Psyche, a goddess/human representing the human soul. They have one daughter Hedone. Hedone is the quest for pleasure with only good consequences. The English word hedonism is derived from this word, but has a meaning far from the original. Eros is also known in Rome as Cupid. Might we begin with medicine and the trenches of the ICU with an experiment in EROS? Might this expose the Apollonic torture around us in the name of love?
