I wish hereby to lay claim to the invention of the phrase “critical but stable”. Here’s how it happened.
In 1990 I was one of the anaesthetics registrars at a big city teaching hospital. It was a most dysfunctional department as the professors and consultants were all permanently at war with one another. God knows why. From the junior doctors’ perspective it felt like being the children of divorcing parents, only multiplied many-fold. I had never experienced such an unhappy atmosphere at any of the hospitals I had worked at previously.
Every evening, after a day’s bathing in this emotional sewage, I would retire to my grimy hospital accommodation and stare at the ceiling until weariness overcame me and I fell into the arms of Morpheus. Occasionally, on a brighter evening I might even attempt to read a book. Somewhere in my bookcase still resides a slim paperback volume with a cigarette burn on its front cover from when I had drifted off during one of its more taxing passages. The book was “The Cloud of Unknowing”, which I had bought on impulse somewhere, thinking it must be about anaesthesia or something. Duh!
It wasn’t about unconsciousness, or subconsciousness, or even consciousness.
It was about super-consciousness: the melding of one’s mind, heart, and being with God’s! It is a classic work of spiritual literature, and one of the deepest. At that time, I was dabbling a bit with spiritual stuff, though only at the most basic amateur level.
Anyway, I digress. One day in early Summer I think, I was on 24 hour duty for the intensive care unit when I was summoned urgently to attend A&E. A patient had arrived from the local prison, who had hanged himself using strips torn from his bed sheet. His heart still beated, thanks to the basic life support afforded him by his warders, but he was in the deepest possible coma. I performed the needful and then took him up to ITU, intubated and ventilated. No sedation was necessary as he was already insensate.
We were accompanied at all times by prison warders who clinked with chains and handcuffs and keys as they sauntered along. The prisoner, I learned, was serving a full life sentence, for killing a cop. He was a very special guest of Her Majesty’s.
Prisoner X got parked in one of the ITU bed spaces and a ventilator did his breathing for him. As I was writing up his notes, the phone by me rang, and I reflexively picked it up, identified my self and then listened.
“Hallo, Can you tell me anything about the condition of Prisoner X at this time?” spake the rather weaselly male voice at the other end of the line.
I was caught on the hop, I was preoccupied with his admission to the unit, I was writing up the notes, I wasn’t thinking straight. I didn’t think who this caller might be.
Even so, I carefully began to reply: “I would say his condition was critical-“….
Then suddenly my good sense kicked in. Who the heck was my interlocutor? Was he this man’s crime boss, his collaborator, a hitman tasked with taking him out, or worst of all a presstitute/journalist sniffing out a gory story?
I paused , then continued: “-but stable”.
The voice quickly said ” ‘Critical but stable’, that’s great doc, thanks a million!” then he hung up.
That evening on the ITU rest room telly, the news programme described Prisoner X’s condition as “critical but stable”. I gaped like the idiot I was at the speed of modern news dissemination.
The next morning, the lady Consultant in charge of ITU arrived in the coffee room . She was a stunning woman of outstanding intelligence, and clearly a beauty in times past, though was ageing badly, and was grossly embittered by a nasty public divorce.
She surveyed the coffee room like a peckish velociraptor might. (That venue was the default refugee camp for all the scared abuse-suffering junior anaesthetists at that particular house of healing you see).
“Which of you lugubrious layabouts spoke to the Press yesterday?” she asked quite plainly but with the threat of torture implicit in her mien.
I realised that this was not an occasion for us all to rise up and declare “I am Spartacus!”, and so I stood up alone in readiness for great punishment.
With eyes and demeanour downcast, Japanese submissive style, I admitted my responsibility, and awaited my doom.
The monster lady’s face quite unexpectedly melted into a rare smile. “Well done Doogie!*”, she said, almost with affection. She continued,
“By the way, what the fuq does ‘Critical But Stable’ actually mean?”.
*Due to my meek, mild and innocent demeanour at that time, I had been awarded the nickname of ” Doogie Howser”. Look it up, if you are still reading and interested 😉