The Power of Denial

'AOLE MAKOU E HO'OHIKIWALE KELA

As a critical care nurse I often see denial in its ugly maladaptive form. The 27 year old methamphetamine addict with a heart more effective at holding helium at a kid's birthday party and tied to a string than circulating a sufficient volume of oxygen laden blood. Sadly, this is often a sealed fate. The sole family member and DPOA that is determined to push on and continue care despite the patient's wishes and clear evidence of medical futility. The ICU is a form of torture is these cases and is one of the greatest challenges ICU RNs and MDs face. You learn to accept this as part of the ICU and do your best to educate family members with honesty and tactfulness. This is an art. Our medical and nursing establishments bear great responsibility and need to take a hard line; we can do amazing things, but there is still much we cannot fix. I find many family members expectations of medical care grossly unrealistic. I meet all of this with compassion and empathy and realize that in the ICU we truly see people at their worst and sometimes paradoxically at their best.

I wonder what humans could accomplish without the power of denial. It certainly serves the purpose of softening the blow and giving us time to adapt to varied insults. It also allows us to dream big. My mind naturally gravitates toward the grandiose and enjoys mixing concoctions not fit for eating or drinking by most. It is not that these concoctions are inedible, just that they are not very palatable at first. They are a delicacy and you have to want to try them.

Having not completed the Big Island Traverse route or the distance, much remains uncertain and I still have great, although lessening, amounts of denial, Soon to be replaced with the rich and powerful wonders of reality. I am mentally and physically prepared and simply excited to hit the trail. A great experience lies ahead and I look forward to a potent exchange with nature at her best. Thanks to all of my family and friends and see you in a few days.