Articles

Reflection on Pediatrics: Rotation 3

In Uncategorized on September 29, 2012 by David

For the first five months of third year, I have been rather shielded. I have seen a few emergencies, scrubbed in intense surgeries, and seen very sick patients, but for better or worse, I have never seen a patient pass away. Major things happen and tragedies occur, but I had never seen it firsthand. I would hear about it through sign-out, or in passing, or through notes, but I had not experienced it firsthand. Medicine is long lulls of calm punctuated with sudden, rapid, and chaotic activity.

I was on my week at the newborn nursery and spending a night with the delivery team and the intensive care nursery. I had been forewarned about this delivery, a term neonate with significant defects including malformation of his lungs. He was comfort care – he wouldn’t live long, but the goal was for him to spend some time with his mom and to let her hold him before he passed away. The resident saw that it was already pretty late at night, and asked if I wanted to go home. I thought it was an important point in my training, and even if I wanted to, I couldn’t turn away. I could go home, but what kind of doctor would I be if I could not deal with death?

The delivery started at 10:30PM, when most of the day time visitors, the volunteers, and much of the hospital staff had gone home. The baby came out blue, floppy, and not breathing – a bad sign that could mean poop stuck in the baby’s airway, significant lack of oxygen even in the womb, or many other things. The neonatologist immediately intubated the kid, breathing with a bag mask, putting in IVs, warming and cleaning him off. The kid’s face was misshapen – smaller and more narrow – and getting a tube in his mouth to breath was hard. Flicking him on the foot, he would not cry but would open his eyes and weakly moved his arms. They listened for lung sounds, heard a faint heart rate, drew blood to check his oxygen levels, they were low, and gave saline through the umbilical vein. After a while, his oxygen levels were going down and his chest was no longer moving. What happened? X-Rays were taken and he was reintubated. Flicking him on the foot, after a while, he would not move. He just looks asleep. It’s sad when an adult dies, but it is a Greek tragedy when an infant passes away.

It was about 1AM when I got home. I was in shock when the dad came by to hold him. I felt so distant and so emotionless when we took him to be held by his mom, to be baptized. I felt numb, distant, cold as I walked home through the fog. I wanted to talk, but I didn’t know what to say. I wanted to journal, but no words went on the page. I wanted to call someone, but couldn’t think of anyone to call. My classmates were all busy with their own rotations; no one would want to be bothered at 1AM in the morning.  It would be strange to talk to people I haven’t talked to a long time, or to talk to someone about this who wasn’t in medicine. I wanted to call my parents, but didn’t want to bother them – my dad was sick at the time, and I was worried that my mom would be superstitious and take it as a bad omen. I had no one to talk to, and it felt very lonely.

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One Response to “Reflection on Pediatrics: Rotation 3”

  1. Next time, call me at 1am! You’re entitled to one “get out of jail free” card

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