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.