The art of medicine - "A taste of your own medicine": the experience of a transplant

Sep 29, 2026

Uploaded by dabgoudw

First-person reflections after a double lung transplant in a UK intensive care unit describe confusion, pain, fear, hallucinations, and the loss of speech caused by tracheostomy. The narrative traces sensory overload, persistent thirst, medical monitoring, and communication barriers, then the temporary return of voice via a speaking device. It follows recovery through infection control, therapy approvals for eating, and gradual removal of tubes and lines, emphasizing patient agency in treatment planning.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Recovery after a double lung transplant

ICU confusion, pain, and communication barriers

Sensory overload and medical routines

Regaining voice and gradual recovery

Europe PMC unders uthManuscripts Europe M eC und Author Manuscripts | Europe PMC Funders Group
Author Manuscript
Lancet. Author manuscript; available in PMC 2026 January 06. | | --- | | Published in final edited form as:
Lancet. 2025 April 12; 405(10486): 1220–1221. doi:10.1016/S0140-6736(25)00691-9 .
The art of medicine “A taste of your own medicine”: the experience of a transplant
Havi Carel
Department of Philosophy, University of Bristol, Bristol BS6 6JL, UK.
It’s done. You’ve had it.” My partner is grinning widely. I open my eyes but have no clue where I am. He tells me I had a double lung transplant and I am in the intensive care unit. At first, I am confused. Then in pain. Then frightened. I doze and wake, not sure if it is a new day, or whether it is daytime at all. I do not understand what is going on around me.
My glasses are in a box somewhere and it takes a few days for me to convey that I need them. In the meantime, I have double vision and everything is blurry. My fentanyl-addled brain marvels at the staff around me in the UK National Health Service (NHS): these synchronised pairs, wearing matching uniforms. Here are the twins that empty bins. Here are the twins that clean the floor. I hallucinate, trying to piece together my fractured reality. Istare for hours at what I take to be a truly alarming Halloween display (it is August) and take comfort from the small girl sitting next to me quietly reading a book. I am upset to find out my mother is lying in the bed next to me, having sustained a head injury on the way to visit me. I am stressed about the storm and our evacuation to the roof, which goes very smoothly indeed: I didn’t even get wet. I recall a nurse coming to me and saying “you’re taking too long. You’ve got 48 hours to get better or we’re going to stop treating you”.“Please”, I say,“please, what about my children?
I contemplate escape but realise I’m tethered to a ventilator, a central line, electrocardiogram machine, and more monitors than I can count. Lying down, I labour to work out what is happening, try to listen to the nurses’ whispered handover conversations. Gentle hands wash and clean me; attention is lavished on me: observations, blood tests, x-rays (those twins with the portable x-ray machine). I get turned over with daily (and more) bedding changes. I am baffled by how I am still alive, without eating or drinking. My burning thirst is indescribable.
This mess inside me cannot be articulated because I cannot speak. I have no voice because of the tracheostomy. I am given a laminated sheet with the alphabet printed on it. But my hands are too shaky and brain too foggy to use it. So I lie there trying to get some mental order back, despite the bodily chaos. I am shown a schematic diagram of my tracheostomy. I am perpetually terrified that the little balloon in my trachea will self-inflate leaving me to
This work is licensed under a BY 4.0 International license. Correspondence to: Havi Carel.
havi carel@bristol ac uk | Europe PMC unders uthManuscripts Europe M eC und Author Manuscripts Carel Page 2 suffocate in silence. (Note to anaesthetists: please do not put a patient on a ventilator without warning and then say “don’t bother trying to breathe”. It is very disconcerting.) One day, a physiotherapist comes with a small box. It is a voice—my voice. She inserts it into the tube connected to the tracheostomy. Suddenly I can speak and be heard. But they take it away after a few hours (I am still ventilated some of the time) and I am bereft. I once again cannot explain anything I think or want or need. I am voiceless not as metaphor but fact. I am barely an epistemic agent at all. I want my old body back. Everything in my new body hurts or stings or does not work or all three. I am exhausted and uncomfortable and my wounds are infected and need to be reopened—vacuum pumps are added, as is a weekly visit to theatre for debriding. Slowly—extremely slowly

FAQs

How does the recovery process progress from ICU to later care?

She slowly improves, receives approval to eat and drink, remembers and thanks staff after tubes and lines are removed, and after three weeks is moved to a high dependency unit with more stability.

Sep 29, 2026

Uploaded by dabgoudw