Posted by: Dr. Thunder
It is in some ways ironic that the birth of this blog features a post that dwells on death.
I’ve spent a lot of time today asking myself if there is something wrong with me. I mean apart from the obvious! I’m talking about my abilities as a doctor. I tick most of the boxes.I think my clinical skills are reasonable. My theory is OK. I get on with the staff that I work with. But what I mean is do I react appropriately to emotive situations? Am I kind and sensitive enough to be a paediatrician? Am I the type of human being that people want near them in their most difficult hour?
Let me explain:
I was on the night-shift last night. I’m a junior paediatrician in a very large children’s emergency department in the UK. In the early hours of the morning the paramedic link-radio crackled into life at the nurses station. Ambulance control told us there was a crew enroute to the hospital with a 4 year old girl. “She has no pulse and she’s not breathing”.
A+E sprung into action in the way that it does. Drugs were prepared. Life support machines were cranked up. The intensive care team turned up. Even the surgeons popped in to see if they could help.
Nobody could help.
The long and short of it was that this beautiful little girl died long before she was brought into our department. It looks like she passed away in her sleep. We don’t know why yet. We tried our best to save her, but there was no hope. We gave her about 20minutes, without even a flicker of life.
As we gave up, the room was full of tears. It’s common after a paediatric death to see experienced staff crying. Everyone pulled it together as we called her parents and her older sister into the room.
Agonising, anguished howls filled the department as this poor family was torn to pieces by nature’s cruel hand. Looking helplessly down at your still, cold child is a situation I can’t even imagine being in.
When the commotion died down, and the family were sitting in the relatives room with the hospital priest, the A+E staff had their time to grieve. I walked into a darkened room, as doctors, nurses and auxiliaries all sat together. Nobody said anything. More than half of them were still crying. This isn’t a typical scene in an adult death, but it’s pretty common after an unexpected death of a child.
I don’t really work like that, though. I felt terribly sad for the family. My stomach churned when we called time on our resuscitation efforts. But I wasn’t upset in the way my colleagues were. I didn’t know the child, and I didn’t know her family. I spent about 15 minutes doing chest compressions on her, though. I was there in her final moments. But I wasn’t overly upset. I’m the one who went to see the next patient 5 minutes later, a toddler with an ear infection.
I’m not trying to be tough by saying any of the above. I’ll freely admit I cried when I lost my first adult patient as an intern, and I cried the first time I lost a baby at her delivery when I started paediatrics. I just wonder why I wasn’t upset, while grown men in our department shed tears. Why am I not affected like everyone else?
Some people say that when you stop being upset at a child’s death, then it’s time to leave paediatrics. Maybe this is true. Maybe I don’t have the emotional capabilities to do this job. Maybe we need people who can just get up and move on after tragedy. I don’t know. I’d be interested in the thoughts of others though.
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