Wednesday, February 17, 2010

A Mother's Cry

It happened again last week. Among the hustle and bustle of a crazy shift. A pre-hospital radio call from an ambulance team that nobody ever wants to receive.

"We're bringing you a child in cardiac arrest."

Noooooooo. Word traveled quickly through our staff, and the mood immediately got very somber as everyone prepared the resuscitation room for this child. We could only pray that the child being brought to us would respond to our life-saving measures.

Nurses ran to get the intubation and IV trays, pharmacists ran to get the resuscitation cart with all the emergent medications, techs ran to get the EKG and ultrasound machines, and respiratory therapists ran to get a ventilator. Two of us physicians were working with a slew of residents, and we all reviewed our mental checklists and tried to enter our objective frames of mind. Organized frenzy.

My partner requested to be the lead physician during the resuscitation. Being young and recently-trained, he wants to save the world. We all want to save the world, I guess, but for now we'd focus our energy on saving this child. I assured him that I would stay in the room and help with the resuscitation efforts.

The ambulance arrived. With a sad nod of his head, a trusted paramedic gave answer to our searching faces. No response. Yet. We all caught our breath as our hearts plummeted.

We transferred this child to our hospital cot. We emergently intubated this child, checked for any pulses, and continued CPR when we found none. IVs were hard to establish, so I started an intraosseous line by sticking a needle into this child's left tibia. Aggressive fluids were given. Medications were administered. Ventilations were forced into uncooperative lungs.

Efforts continued. My partner followed the life-saving protocols but didn't get any response from this child. Prayers were whispered. Seconds were watched as they ticked on the clock. Slowly, as slow as any time had ever passed, a heartbreaking realization permeated the room. We might not succeed.

My partner ran to the family room to discuss options with this child's parents, while I continued to follow all the resuscitation protocols. We had nearly maximized all of our medications. And still...nothing. CPR was continued, ventilations were continued, more medications and hydration were given.

My partner returned to the treatment room. He looked at me expectantly, and I shook my head "no." My partner shared his conversation with me. Dad was still at work, and Mom was in the family room with our social workers, waiting for family to arrive. She had been invited back to watch the resuscitation efforts, but declined. Her child had been through this once before, because of chronic, ongoing medical problems, and had survived. Surely, she thought, her child could survive again.

After almost an hour of failed heroics, with absolutely no response to any of our interventions, we confirmed what we were most afraid of. There were no palpable pulses. There was no cardiac activity, confirmed on monitor and with our bedside ultrasound. There were no spontaneous respirations. There were no signs of life from this child.

There would be no miracle.

My partner asked if anyone in the room objected to his prounouncing this child's death. Nobody objected, since we had all been involved in trying to save this child's life. We knew the efforts that had been put forth were monumental. No attempt had been spared by our team to bring this child back. Unfortunately, and for unexplained reasons, the fates held different plans. My partner announced the time of death.

I requested a nurse to clip some of this patient's hair for the family. I crossed myself after my silent prayer. I fought my tears. Hell, we all fought our tears. I consoled my partner, who, like me, has three young kids of his own. Slowly, a wave of profound sadness and nothingness swept across us. What good are any of us if we can't save a child's life? My partner went out to the family room to deliver the awful news.

Then, time stood still. From two hallways away, I heard the haunting sound. A sound that I knew was coming. A sound that is played over and over in my mind for days after an event like this. A sound of profound anguish. A sound of utter disbelief. A sound of infinite pain.

A mother's cry.

Slowly, as we all knew would happen, the mournful wails of crying crescendoed, and our emergency department came to a stand-still as Mom was escorted through our halls into her little child's room.

Despite our best attempts at maintaining our objectivity, and despite the fact that there were many more patients waiting to be treated, our ER staff cried collectively and gave consoling hugs to one another. We are mothers. We are fathers. We are brothers and sisters. We are sons and daughters. We are friends. We are human. And, we were broken.

Dad arrived just minutes after Mom was escorted to the room, and the cries of desperation were repeated. This time, husky and deep. Slowly, though, his cries softened and dissipated, until there was but one lone cry that began again. Higher-pitched. Guttural. Primitive. Emanating from the womb. A cry that conveyed the raw anguish and helplessness that only such a profound loss as losing your child could bring.

God Bless this mother. God Bless this father. God Bless this child. And may God Bless and watch over this family. And all of us.

If only life were filled with just happy moments...As always, thanks for reading. Next post will be either Friday, February 19, or Monday, February 22. See you then...

42 comments:

Chrysalis Angel said...

How very sad.

Cathy said...

I am speechless. So very sad. I am sorry!

Heather said...

That is a fear I fear daily. Thank you for putting a face to chronically ill babies and their momma's.

And bless you and your team for not being jaded enough to forget what life is about.

Lynn said...

A Mother's cry will be heard forever over her childs death. I can't begin to imagine what that feels like. I have 3 boys and when I read blogs about kids being sick and dying, it just breaks my heart. I'm a believer in God, but sometimes I just don't get why he lets things like this happen.
God bless you all working in the medical field and God bless the family.

rlbates said...

How very sad

Christine Claire Reed said...

OH...I am so sorry. You know that the tears of you and the staff were gifts to that child and his parents. Grace-filled gifts, saying, I see you and I feel this too, you are not alone.

Katie said...

Thank you for bringing this child to life through telling his/her heartwrenching story. I pray the Lord showers this family with love and comfort as they go through this hard time. (The ER team, too).
<>< Katie

kristi said...

OMG, this is so sad.
My son was struggling to breathe when he was born. Nobody told me anything b/c I had a c-section and was in recovery for awhile. I am thankful to have him, autism and all.

Cal said...

What a sad story, very emotional, I cannot help being touched by it. No doubt all of us who have children of our own cannot help momentarily to imagine ourselves in that mother's shoes, and our heart breaks a little just for that. We quickly step out of those imaginary shoes and thank our blessings.. I bet you hug your kids extra tight at the end of a day when something like this happens.

BLACK INK said...

God has blessed you with a very special gift and calling.

terri c said...

Profoundly moving and beautifully written.

911RN said...

By far, THE worst part of working in the ER! Pediatric codes.We reside in a coastal, resort town and not only do we have the usual SIDS, traumas etc. that can result in children/infant deaths but every summer we get 1-3 pediatric drownings.These can occur in pools, ocean or the sound. Most of these folks are on "vacation" and lose their child while they are supposed to be having a relaxing, family, "at the beach" vacation. Then they lose a child- nothing could be worse! Heart wrenching when it happens. Sorry, doc. Know your anguish- have been there.

t. said...

Thank you, Doc, for your work. I am truly sorry for your loss.

Maha said...

I can't even begin to imagine those parents' sorrow. I'm so sorry.

MLee said...

I was so praying for you to say that the child made it. This is example of our worst cases. The sounds of every patent's family grief always leaves a mark that we put away, but never forget. Children are the hardest.

Stephany said...

This, is impossible to read without tears blurring my vision to type. Horrible grief.

Marie said...

Thank goodness you can still cry.

In the midst of that nightmare, those parents were fortunate to have such a compassionate team.

I'm so sorry, because I know it was a loss for all of you as well as for those poor people.

Your writing continues to awe me with each post.

Tonjia said...

it is never easy... no matter how many times we go through this, it isnt easy.

All you can do is just what you did. Say a prayer, shed a tear and after you finish your shift, go home and hug your kids....

rheumablog said...

What a sad, wrenching, and well-told story.

Dr. Woof-Woof said...

Thank you for sharing this story. I can only imagine the grief that must have been splitting the parents' hearts.
I know that each of you working in the ER feels the grief in a different but very profound way. I work with pets, and seeing a family's grief, hearing their wailing, it cuts to my heart... I can only imagine what it might be like to be in your shoes, dealing with human souls, and the family members left to mourn their loss.
God bless you for all that you do - and may He comfort you as you go about your work.

RealWomanFromIndiana said...

Being in education, there are too many children whom are better off dead!

Amanda said...

I've heard that cry only once. My daughter (4 months old) was in PICU, her 2nd heart surgery. We'd been there a while. There was another patient there - same age, same heart defect. My daughter was even slightly more complicated. The other patient died. The PICU team tried for what felt like hours. I will never forget that mother's cry. It's a primal sound. I will never forget standing by my daughter's isolette and not understanding why my child was still alive. I was (and am) so incredibly grateful. But I couldn't stop crying that day. Not for a long, long time. Thank you for posting this incredibly well-written story. What a service you provide for these families.

StudentDoc said...

I'm sorry!
I'm so thankful that in my short time as an EMT I never had a kid this sick - the worst I ever got was febrile seizures. Watching a 30 year old die of something she shouldn't get until 70 was the hardest thing I've dealt with, I couldn't even imagine doing the same with a kid!

Carolynn said...

oh shit.

I pray to God I never hear that sound.

My thoughts are with you, your colleagues, and the family.

missdani said...

I have heard this cry, after working in an ER for 14 years. It never gets "easy". You carry with you these patients and their families forever. God bless you and the work you do.

SeaSpray said...

I am so sorry Jim.

I am deeply moved and crying. Hard to type through tears.

I am sorry for your loss.

Thank God for medical people like you who are able to help us in our time of need and for the lives you do save, the pain you relieve and the healing you facilitate.

MLee said...

"RealWomanFromIndiana said...
Being in education, there are too many children whom are better off dead!"

Just a tad harsh. I guess compassion, empathy, and understanding can't be taught. and, we all can see were the saying came from in your case, "those who can do and those who can't teach."

Marjorie said...

So utterly and completely heartbreaking... Another beautifully written post. Thank you for sharing.

coulrophobic agnostic said...

It always seems to be the cherished, beloved children who die in such horrible ways. Meanwhile, the kids pumped out one after another by people who can't be arsed to use birth control but have no interest in raising them will bounce if dropped from ten stories up.

Not that I want any of them dead, but god I just feel so badly for the parents.

Nikita said...

How desperately sad and moving. It is the first time I have been moved to tears reading a blog.

Lynda Lehmann said...

Heart wrenching. What more can I say?

Medblog Addict said...

Congratulations on winning 2009's Best Literary Medical Weblog!

Mike said...

Tough story to read...but unfortunately a reality in this world.

Thank you for all that you do to serve mankind. I'm glad there are people like you willing to help those in desperate need. It's not a job many could perform. You are a special and compassionate man.

girlvet said...

..and it is so hard to know what to do. The family is in agony, we are complete strangers. How do you console them? I guess you just be there with them. You did your best.

NurseExec said...

Congratulations on winning Best Literary Medical Weblog!

David Head said...

I've heard this mother's cry as well and it is something I will never forget. Thanks for trying so hard and for caring so deeply. Rest in Peace Child.

David Head said...

I've heard this mother's cry as well and it is something I will never forget. Thanks for trying so hard and for caring so deeply. Rest in Peace Child.

StorytellERdoc said...

All
Your compassion and kindness, especially for this family,in your comments and your personal emails to me regarding this post, are simply astounding...a true testament to the goodness that we all carry inside us and the shared pain we feel for another's misfortunes. Thank you, thank you.
Jim

Leigh Ann Otte said...

Wow. Thank you for this heart-wrenching glimpse into the real world of medicine.

Anonymous said...

Working in a peds ER, I can say I know this cry all too well... it's hard to even put words to it. The absolute worst sound in the world.

Have Myelin? said...

My daughter died June 10, 2009 from multiple organ failure and she was only 34 years old.

I can barely stand it even now. Truth be told it is harder later than in the beginning because you have to figure out how to live without your child.

Poignant story.

Chrysalis Angel said...

Have Myelin, I am so very sorry for your loss and your pain.