Alice in Intensiveland

This following is excerpted from "Alice in Intensiveland. Being an Essay on Nonsense and Common Sense in the ICU, After the Manner of Lewis Carrol!" by Robert H. Bartlett, MD, FCCP in CHEST 1995; 108:1129-39. I recently read this article, which is a really amusing and impressive allegory of Alice the Medical Student contributing to ICU care by applying her basic knowledge of physiology.

"Being a medical student, Alice perceived the hospital as a place of wonder. Being a medical student, Alice thought of herself (if she ever thought of herself) as intelligent, practical, educable, compassionate, and potentially competent to care for the sick. All she needed to accomplish this task was knowledge, and armed with 2 years worth ofbasic facts, she now sought to acquire that knowledge in this Wonderful Place. She had, metaphorically of course, consumed and deleted, grown and shrunk, read the lines and between the lines, and passed through her own reflection to get here. Now she was ready to begin the grand adventure. That was when she saw Dr. Rabbit.

Dr. Rabbit was hurrying down the hallway, walking so briskly and looking so nervously at his watch that he nearly knocked her over. White shoes, white pants, white tunic covered by a white coat stained by some unidentified biologic fluid. Dr. Rabbit was an intern, but he looked like a White Knight of the Wonderful Place to Alice."

The story then describes Alice confronting the ICU team about treatment of shock, ventilator settings, and other problems for which we occasionally blindly treat without thinking of the physiology. This story features this poem (about how the radical is blamed for things it shouldn't be):

"Jabberwoxy
T'was septic and the slimy rods
Did gyre and gimble in the blood.
All mimsy were the neutrophobs
More air to fuel the flaming flood.

Gramneggars sting and conflagrate
The neutrophobs perfuse acquire
Good oxygas to generate
a Jabberwox to feed the fire.

With vorpal sword well catalyzed
by iron and selenium
Jabberwox killed bugs despised
and mayhaps endothelium.

Dilemma lacking common sense
A preconcepted man could make
On Jabberwoxy evidence
A categorical mistake.

So good or bad it has become
A scientific fadical
For most of academicum
To ridicule the radical.

Twas septic and the slimy rods
Did gyre and gimble in the blood.
All mimsy were the neutrophobs
More air to fuel the flaming flood."