Mechanical Ventilation and the Art of Helping Patients Recover in the ICU

“A man with a conviction is a hard man to change. Tell him you disagree and he turns away. Show him facts or figures and he questions your sources. Appeal to logic and he fails to see your point.”
― Leon Festinger, A Theory of Cognitive Dissonance

One of the things we admire about medical doctors is their dedication and hardwork. This combined with experience brings about a deep appreciation for the adage "Change is the only constant".

In one of my early conversations with my advisor who is a leader in critical care, he stopped me in the middle of a sentence and said this:

Ramm, there are not SOME improvements that can be made. There are 100s of things we can do WAY better!

An always learning mindset among the fraternity is important in saving lives.

But once in a while, you come across those who certainly need to do better.

The below is an interaction with one of them

---

March 2024

5 weeks in the ICU on mechanical ventilation, what would be the signs that there is some improvement in the patient, doctor?

Duh! There's no hope of such recovery!

Be that as it may, if there indeed is a possibility, what would those improvements look like?

...silence...

Have you considered x?

There is no role for x in the human body!

Really? Didn't someone get a nobel prize for discovering the very same thing in the 1990s?

I don't think your google knowledge is relevant here.

How about all the publications in your medical literature proving their extraordinary relevance in critical care settings?

...silence...

---

Probably less than 1% of ICUs today use this intervention to improve outcomes for mechanically ventilated patients in their critical care.

If you are a leader in critical care in any major city, we would like to hear from you

- SafestDoctors

All of us experience cognitive dissonance at some time in our professional careers.

It's never too late to set aside our ego and consider possibilities from a first principles appraoch.

“The existence of dissonance, being psychologically uncomfortable, will motivate the person to try to reduce the dissonance and achieve consonance. When dissonance is present, in addition to trying to reduce it, the person will actively avoid situations and information which would likely increase the dissonance.”
― Leon Festinger, A Theory of Cognitive Dissonance