Wednesday, March 27, 2013

Non WoW post: Even if it's not you, it can still make you cry

Deviating from WoW talk for a bit... but a warning - this post may make people cry.

Today was just one of those depressing days at work.  I come to work and find out that two of my trainees had to deal with a horrible experience yesterday and need to debrief and neither of them are at work today, understandably.

Yesterday there was an emergency call for anaesthetic assistance for a 17 month old child who choked at home and turned blue.  The ambulance officers had arrived to the emergency department doing CPR and ventilating the patient who had no heartbeat for 15 minutes already.  My two trainees went down to help resuscitate the child but after a further 20 minutes there was still no heart beat despite multiple doses of adrenaline, and so the child was pronounced dead.  My heart goes out to the poor family of the child and for everyone who was involved.  I know from experience that every time a child dies, all the hospital staff involved are all understandably very upset and in need of a debrief.

This is on the tail of a lady who had conceived through IVF and somehow had missed follow up and turned up at 42 weeks and 3 days having not had her baby.  The baby was in distress when the midwives assessed her, and she was organised for an urgent Caesarean which was done immediately but the baby was born floppy and pale and CPR was commenced immediately.  At 42 weeks her placenta had given out and could not give enough blood or oxygen to the baby.  The baby was whisked away immediately to the special care unit, still having CPR but it was looking pretty grim. Deaths of babies is uncommon and it's hard for staff to know what has happened.  I cringe when I think of the recovery nurses who immediately ask "Oh, congratulations, what did you have?" when they hear someone has had a Caesarean  - they are not doing it to be mean, it's just a small thoughtless thing because we've assumed everything has gone ok.  The husband had come out with the wife to recovery, which is not the usual protocol, and the neonatal doctors came down to speak to the husband and wife.
"We've done everything we can for your baby, but we were unable to revive him.  If you would like to come up and say your goodbyes..."
The wife was undecided.  She said to her husband, "I don't know if I can do it.  I don't know if I can see him.  I still feel so numb, that this isn't happening."
"You should see him," her husband said.  "You'll regret it if you didn't."
I cannot imagine what was going through both of their minds as they held their dead child, covered in drips, breathing tubes and IV lines - none of the interventions used in resuscitation are allowed to be removed if the patient is to be sent for a post mortem.  It's an awful thing, for a parent to see - something that looks so unlike your own child, more like some kind of machine with all the bits of medical paraphernalia attached.  Those months of joy and expectation, their precious baby that was difficult to conceive, and never even getting to know their new baby...

I still have tears in my eyes hearing both of those things.  Neither of which was directly involved with me, which would probably have upset me even more, but being the Supervisor of Training means that debriefing and coping with death and loss and failure is part of helping my trainees on their way to becoming specialists.    Though undoubtedly the hardest part of loss of a child is to the parents, the constant facing of death and failure to a medical practitioner can be very stressful.  Detach yourself from it, and you risk becoming a cold unfeeling practitioner.  Getting too emotional about it can lead to work stress and depression.  Somewhere in the middle is what we have to strive to be - and encouraging my trainees to talk about it and debrief, even if they say they are ok, is part of the coping process which I hope they will learn and pass onto their own trainees in the future.

Stories like that of Liala, Chris and Lilpeanut who have lived through the death of their own child, are so terrifying to me.  Some may wonder, what is worse - losing your child before you got to know it, or losing it after you had lived with them, and shared their life and seeing their potential and then losing it... I think that each is a tragedy, and neither is worse than the other as it is from each parent's perspective, their OWN child.  Whether your child died at 0, 3, 17 or 40, they were always your child and no parent wants to outlive their own children.

Every day I hold my daughter and my son and I tell them stories of real children who have accidents and end up dying.  My daughter still remembers the stories I tell her - of the 4 year old whose hat got blown off her head whilst crossing the road and she let go of her mother's hand to go get it and was hit by a car and died.

Accidents, health problems, cancer - you can't control them.  I can understand the terror of some parents who would do anything to protect their child from harm, and their child ends up living their life in a bubble.  But you cannot control death or save your child from every evil.  I wish I could protect my children from all harm, but I look at them everyday and know I cannot control their fate.  Bad things could happen.  I just hope and pray that a day like that will never happen to me.

10 comments:

  1. I've said this before, Navi. I admire the strength you must possess to be able to keep going back. To keep fighting for the next one. To keep trying so hard. And I respect your courage. Above all, though, I respect that you haven't become one of the doctors so many of us hear of, who detach and.feel nothing anymore.

    That heart makes you a better doctor. My thoughts are with you.

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    1. Thank you Hyperious. I wasn't trying to garner sympathy or praise, for me my way of dealing with sad stuff is to talk about it. Thank you for reading and know that there are many doctors out there who feel as I do. Hugs to you!

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    1. Thank you Sprowt! Sorry you had to read my sad stuff /hug

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  3. Oh, oh, Navi! The tragedy of that second story just breaks my heart. My own infertility has been very difficult to bear, and I hope I never have to experience the loss of a child -- whether my own, or a nephew or niece -- but to have those two things compounded...! I am crying and crying just thinking of the horror and anguish and despair that poor woman and her husband must be feeling.

    You are an excellent role model for your trainees. I hope they open up to you and learn from you how to hold that delicate balance. ((hug))

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    1. It is horrible, I had tears in my eyes at work and I feel for those poor families. Thank you for the comment and I hope that I never get jaded in my old age!

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  4. My dear, sweet Navi. I am so sorry to hear these tragic stories. Sending you massive hugs xx

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    1. Hugs to you Neri! Thank you for the comment <3

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  5. The wifey and I were talking about this the other night, we know several people who have lost little ones at a very young age. We can't imagine what parents go through to lose a son or daughter at any age. I had a former boss who lost two children to nuchal cord births; fortunately for her, she was blessed with a healthy daughter on her third pregnancy. My thoughts and prayers go out to all those who have lost children.

    The world is a better place with people like you around, able to help others cope through tough situations like these. Hang in there Navi, you're doing a good job.

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    1. Thanks Arv :) sometimes the job does get you down but there are enough uppers in my life to help.

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