Tears
I've been meaning to write but this month is wearing me down.
In pediatrics, we don't see that many deaths. Or at least compared to our adult-counterparts in internal medicine. But a couple weeks ago, I had a baby that died. The horrible part was the way it happened. There was a pediatric code called in the adult ER (which usually means something bad). I was on call that day so I had to stay in the unit, but many of my colleagues went and found a baby that was in full cardiopulmonary arrest, i.e. not breathing and with no heartbeat. To make a long story with too much drama short, the baby was brought to the unit and died.
I had admitted that same baby to the unit not even a full week prior. I had done a full sepsis work up, including a spinal tap that I myself did, before transferring the baby to another team, where the baby was discharged home. In good health.
So how is it that this same baby shows up to the ER, dead?
It's something that I've been thinking about daily since it happened. As I watched the other doctors doing CPR and then declaring that it was futile and pronouncing the death, I cried because it just wasn't supposed to happen that way. Kids, and especially little babies, aren't supposed to die. What did I miss... what did I do wrong... what could I have done to prevent this. How could this baby have been seen by multiple doctors, discharged home, and then die less than a week later?
I don't have any of those answers. I think I've come to a place in my mind and heart that we didn't miss anything. The baby just got really sick again at home and babies are fragile. But it's still hard to walk away.
That same day when I was on call, one of our cancer patients died. And it reminded me of why I like oncology and why I hate working in the intensive care unit... at least in oncology, most patients have a chance to fight. This baby didn't have a chance. She just showed up already dead. One day fine, and the next day, not. That's a lot harder to accept than the death of someone who's been fighting for a long time and for whom we've tried everything.
On that depressing note...
In pediatrics, we don't see that many deaths. Or at least compared to our adult-counterparts in internal medicine. But a couple weeks ago, I had a baby that died. The horrible part was the way it happened. There was a pediatric code called in the adult ER (which usually means something bad). I was on call that day so I had to stay in the unit, but many of my colleagues went and found a baby that was in full cardiopulmonary arrest, i.e. not breathing and with no heartbeat. To make a long story with too much drama short, the baby was brought to the unit and died.
I had admitted that same baby to the unit not even a full week prior. I had done a full sepsis work up, including a spinal tap that I myself did, before transferring the baby to another team, where the baby was discharged home. In good health.
So how is it that this same baby shows up to the ER, dead?
It's something that I've been thinking about daily since it happened. As I watched the other doctors doing CPR and then declaring that it was futile and pronouncing the death, I cried because it just wasn't supposed to happen that way. Kids, and especially little babies, aren't supposed to die. What did I miss... what did I do wrong... what could I have done to prevent this. How could this baby have been seen by multiple doctors, discharged home, and then die less than a week later?
I don't have any of those answers. I think I've come to a place in my mind and heart that we didn't miss anything. The baby just got really sick again at home and babies are fragile. But it's still hard to walk away.
That same day when I was on call, one of our cancer patients died. And it reminded me of why I like oncology and why I hate working in the intensive care unit... at least in oncology, most patients have a chance to fight. This baby didn't have a chance. She just showed up already dead. One day fine, and the next day, not. That's a lot harder to accept than the death of someone who's been fighting for a long time and for whom we've tried everything.
On that depressing note...
posted by Vivian | 1:05 PM
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