Friday, May 7, 2010

A Mother's Cry

Every day is a gift...

Initially, this was posted February 17th, and your overwhelming response and compassion astounded me. Thank you. May it remind everyone of the tremendous treasures we have been entrusted with when we become parents.

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 pronouncing 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.

My most heartfelt wishes for every mother, and mother-figure, for a blessed Mother's Day weekend. May your presence in the lives of those you love be cherished. And may unbridled love be returned to you in deserving, infinite amounts. New posts next week...


Anonymous said...

This story makes Mother's Day on Sunday all the more meaningful.

Jabulani said...

I am someone who was once told I would never have children. I wept sadly. I then went on to have 2 children. I wept elatedly. If I were to lose either of my 2 precious miracles, the anguish would be so devastating I would weep silently, the pain being so sharp, soul-deep, as to have rendered me dumb.
I echo your sentiments: God bless the mom, the father, the child. And you and your fellow staff for all your efforts. Peace be with you.

Heather said...

I can't read this again.

So I Skipped to the comments. ;)

This is my fear every single day...and I only pray that should I be in this situation, I would have compassionate and loving care surrounding us as we grieve.

Heather said...

PS. Happy Mother's Day to Mrs. StorytellERdoc!

SteveC said...

Amen and Amen.

DaddyEMT said...

Story, very very touching post. Missed it the first time around, that feeling of total uselessness is something that I hate about EMS. Unfortunately we don't get to stay to see that every possible thing that could be done was done. I wish sometimes the docs and nurses would ask us to be there. I'm never more terrified as I am in the back of a bumpy rig doing CPR on a small child thinking "just go faster, please go faster"
Thankfully, our ED staff is wonderful to us, and although it's the Fire Dept mantra to not cry in front of others, sometimes you have to.

DaddyEMT said...
This comment has been removed by the author.
tracy said...

i knew i shouldn't have read this a second time...but i did. Rather, i skimed through it. Still breaks my heart, even as i listen to my "baby" (18 year old with AS...and a bad sunburn!) sleep across the hall).
The part that touched me most was the saving of a lock of the child's gives me chills as i write this...good chills.

Thank you, Dr. Jim

Happy Mom's Day to your blessed wife!

Kate said...

There is nothing more painful than listening to that cry. I can't do it. I'm glad that you can.

Katie said...

I've read this story a couple of times before but I read it again and once again it broke my heart. There are still no words to describe the pain I feel for this family and your team.

You are a great writer, Jim; have you ever considered submitting this to a literary magazine?

Oh, and happy Mother's Day to Karen.

<>< Katie

Hip, hip hop, hip hop Anonymous. said...

I read this before and even though I tried to skip over the entire post, my eyes still caught this section:

"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."

It drives me crazy just imagining it. I shouldn't have clicked on your blog today. lol.

Rositta said...

I am a mother and a grandmother. The thought of every loosing any one of them strikes fear in my heart. Mother's Day is no longer a happy day for me. Three years ago, the night before mother's day, my Mom died in my arms. I look at life a lot differently now. Every person should be treated well on every single day of the year not just one designated day. Of course I'm dreaming aren't I...ciao

Mrs.NurseMommy said...

WOW, your words pierced through me in this daunting story...thank you for sharing and thank you for all the lives you DO save!

Nikita said...

Yet again your details are haunting and bring tears to my eyes. I cannot imagine such grief. I do not know how you can cope with it.

My best friend is in a CCU and on the way there I pass Paediactrics CCU. I find it hard to comprehend that there is a God when I pass this ward.

Thank God for your strength Jim and all good people like you.

Webster said...

Happy Mother's Day to your wife, Dr. Jim, and you have a nice Sunday.

WWWebb said...

You've taken me back in time again. I can clearly hear one of the dispatchers, who came from the old black cab companies, saying over the radio: "Put a [Code] Three on it! It's a child!"

Jenny said...

I am a mother of a 5 month old and also a medical student. I am strongly considering E.R. Peds and this post had me bawling by the end... I had to run and grab some tissues before I could finish because the computer screen was so blurred!

Wow. Thank you for re-posting. It is a good reminder to me of why I am slogging through classes/exams/classes/exams right now. Being a doctor is such a privilege, and what we do every day in work can affect people's lives profoundly.

SeaSpray said...

It's a reminder of how precious every day is with our children and families.

I feel silly for my respnse about my son the other day because while a valid parental response it certainly pales in comparison.

Younger son has been going to a local college but will be transfering to a larger (in state) college but plans on staying there)

He is 21 going on 22 in October. he is a man now.

I could not believe the empty nest pangs that shot through my heart because this is the last "baby" leaving!!! of course I did not let on ..but I had some strong feelings to process. And of course I am proud of him and want him to get out there and seize every opportunity.

But to loose a child this way ..or any way permanently's beyond words for sadness.

Thank you for the mother's day wish and may you have a blessed weekend Jim.

Heather said...

i know that cry. when my son was 8 days old, i was told, "usually babies with this condition are operated on right after birth. it's too late now. he's going to die." i'm blessed to say that asher didn't die that day, that just yesterday, hell, just THIS MORNING i was wishing he'd just slow down and relax for a few minutes. but on the other hand... i know what it means when he slows down... so i hope he continues to run shrieking happily through the grocery store for a long time yet.

thank-you for this post. it's beautiful. and heartbreaking. i know too many families whose babes didn't make it.

you're right: God bless us all.