The Seven Year Old I’ll Never Forget
Posted by Dr. Cason on Friday, November 14th, 2008
She was alert and cranky and sitting up making everyone a little cranky too. I’m mean that’s what seven year olds do right? I would have been more annoyed except she had pneumonia and I kinda felt sorry for her.
It was really socked in, a complete white out on one side and with fluid too. She was transferred from a local outlying hospital, full of Rocephin and waiting a possible chest tube. But hanging out in the ER in the mean time and acting cranky. Just like sick kids do. Except she didn’t look all that sick.
My exam was finished and the intern was finishing her excruciatingly long admit note. We always over write when we are beginning and I let her just write and write. I knew she needed the practice.
I turned on some cartoons.
She asked me for a drink of water.
I wandered off and brought it back just in time to hear her father say, “Mommy says she loves you and she’ll be right here”. Her Father hung up the phone, rolled his eyes a little and smiled, “Her Mother spoils her!”
I smiled and left them alone. She was stable with normal vitals and I needed to head upstairs to pump milk for my 6 month old baby girl. That was life at the end of my residency: In between caring for my patients, I would pump breast milk and dream about seeing my Little Miss Blue Eyes after slugging through 36 hour shifts.
Life had changed a lot since becoming a mother – I was learning to multitask more.
Sitting in my quiet little call room, I settled in and started flipping through a magazine while the rhythmic “Vroom Vroom” of the pump droned on.
*Knock* * Knock*
I turned off the machine, “Yeah?”
“Hey! Sheila! They’re coding your kid downstairs”
“Huh?”
What took me many carefully maneuvered minutes to put together… was detached in seconds.
“Did they start the chest tube or something? Was there a complication?”
I stepped out the call room and into the open hallway. I slung my red stethoscope around my neck and took off. Running as fast as I could I tried to get to her .
I rounded the corner and found that she was already in the Resuscitation room. I boldly opened the door. I wasn’t going to knock. I didn’t have time for that. I mean it’s my patient I needed to be in there.
So in I went.
8 people stood still, surrounding her, their faces blank. She lay there unmoving. Grey, with a tube sticking out of her mouth. As if in slow motion I started to move toward her, “She needs oxygen” I thought.
I stopped as the head ER attending called out,“I’m going to call it. Does anyone have problem with that?”
My eyes grew wide and I just stood there.
Stunned.
“Time of Death 3:35pm.”
Later, I was told that she was just watching the cartoons with her mother, when she sat up suddenly and said, “I see colors.”
She stopped breathing.
And never recovered.
She grew out Group A Strep in her blood – septic from the pneumonia.
She’d be 13 by now. I think about her more than any other patient.
Her father is a physician. No-one blames him. She looked good to him, to me, heck to all of us. No one could have predicted it.
And no one has ever forgotten.
This is for you Baby Girl.
Filed in Everything Medicine | 9 responses so far
Kathleenon 14 Nov 2008 at 10:18 pm 1Oh Sheila, what an trial that must have been to go through toward the end of your residency. I can only imagine how much pain this caused you. Sepsis is so easy to miss. Our medical staff have to watch for this continuously with our HIV patients (and the cancer patients too) because of their immune-compromised bodies. I always see cultures such as Group A strep ordered when one of ours is sick, but this is not something many suspect in otherwise healthy children. I can see why it was missed easily.
Sometimes God has plans for those “special little young angels,” and I believe He had a plan for this precious one as well. I firmly believe God’s hands are in all things such as this, and this is His Will. May God always give you, her parents, and all the others involved that “Peace that passeth all understanding” when you think of this sweet little angel. Who knows, maybe she is watching over your Little Miss Blue Eyes from up above. I would sure have loved to know about the “colors” she was seeing – perhaps a glance of the beauty of Heaven.
If you have a chance, read a story I put on my blog about another precious little boy dying with leukemia, and his desire to help others and be a special angel too. Brenden Foster’s days are very numbered, but he is an amazing and brave young man with so much compassion in that heart of his!
Kathleens last blog post..A Child With a Big Heart for the Homeless
Jadenon 15 Nov 2008 at 1:16 am 2oh. my. god. How heartbreaking and tragic.
I can understand why her story has plagued you.
I can’t even imagine having been there…. I guess I wouldn’t make the best doctor!
Jadens last blog post..Thursday Thirteen #6- Thanksgiving Edition!
Nikkion 15 Nov 2008 at 2:08 am 3My heart is sad for her and her family. When I hear stories like this I can’t help but think it’s just an extended version of Grey’s Anatomy. Sadly it is not.
Kylaon 15 Nov 2008 at 5:23 am 4Wow. Just so shocking.
I think I told you about that time K’s pediatrician called me with some test results and then at the end of the conversation, she snuck in a quick, “I had a child code in the office today.” It was so surprising to me, the thought that kids ever code in the ped’s office, but they do. They code in the office, in the ER, in the OR…all over the world every day. Sometimes they make it and sometimes they don’t. Such tough stuff. But what you do helps turn the odds in their favor, that is no small thing.
Kylas last blog post..Yesterday,
Lisaon 15 Nov 2008 at 6:46 am 5The only patient of mine that coded was probably one of the most difficult things to get over, and I am not sure I completely have. I sometimes find myself replaying the events, trying figure out what I did wrong. She came in for typhlitis. See was getting better. I had just seen her, checked her blood sugar and given insulin. Then she called, SOB, agitated and her Port a cath was dripping blood because she had ripped off the tubiung (I think?) while agitated. Within minutes she changed to confused, to unable to speak, to unresponsive and one pupil dialted the other sluggish. The code went on for 40 minutes but nothing. Her autopsy was inconclusive. Embolism? Did I miss something? I don’t know.
Mostly what I won’t forget is the sheer panic in her eyes moments before she died and I could do anything to stop it.
Lisas last blog post..Spa Day
tiffon 15 Nov 2008 at 7:26 am 6I remember my first ‘code’ was on a middle aged man. It was very distressing. He was in a four bedder and no one expected him to die. We did CPR for what seemed like forever but he died. he had cardiac tamponade and it is something I will never forget.
When I became a middy baby resus was very scary. There were two I will not forget. The first was an emergency caesar after cord prolapse. I had just graduated from being a student. He took a while to resus and there were paeds and NICU nurses everywhere, putting in umbi lines and injecting him with medications. I was just up the end bagging. He was revived and then fitted for days and days but babies are amazing things and he made such a good recovery.
The second was after my own son died. Sheila, it was really, in hindsight, a flat baby, who needed a bit more but he rocked me to my very core. I think it was my third or forth shift back and my first in the birthing suite. When he came out flat my head was exploding with I can’t do this but something just happened and autopilot kicked in.
He was fine. He was. I was SO scared though and it was really hard to continue on after that.
I think you just never can tell and perception is everything. My cardiac guy looked great too. He was sitting up and laughing with the other blokes in the room one minute and in cardiac arrest the next.
My first baby resus was in bad shape but made a wonderful comeback and my stunned little guy was really fine but because of my own experiences I was rocked to the core of my being.
You are amazing and remembering and honouring her wonderful. Your little ‘colours’ girl helps to make you who you are. So traumatic for you and changes you forever.
tiffs last blog post..Too Soon
Doton 15 Nov 2008 at 7:57 pm 7WOW. Life is so precious! My heart feels so sad…
Dots last blog post..Mommy was watching…
Lisa's Chaoson 16 Nov 2008 at 9:41 am 8Wow! That sounds like a bad day if I ever heard one and it makes me really thankful that none of my kids ever had pneumonia. And lucky that I made it through my pnuemonia (106 fever for three days and delirium).
I had lung surgery about 6 years ago now, and had a chest tube and hated that thing. They had to go back into my chest two months later to put some mesh where my lung herniated out my missing rib (from the surgery) and all I cared about was that I now have another chest tube. They assured me I wouldn’t but I’ll be danged if I didn’t wake up with one – I was NOT happy! I will never have another chest tube! I think my biggest issue is that I’m allergic to morphine and demerol.
Lisa’s Chaoss last blog post..The tortoise, minus the hare
Kristinon 16 Nov 2008 at 12:21 pm 9What an amazing story. I’m sure that somehow that child has helped you all these many years. Not sure how, but I’m sure she has.
Kristins last blog post..Tribute to Life