Dying. It is a subject not many will be comfortable talking about. This afternoon, I had attended a discussion centered on withdrawal of care. Back home, I think this would be similar with the concept of HPR or "home per request".
My first experience dealt with a 24+ week gestation infant who required a full blown resuscitation which I had supervised upon her birth. A day three head ultrasound had revealed bilateral intraventricular hemorrhages with parenchymal extension. We had a family meeting which I thought was just to disclose these findings to the parents and the implications for the future should she survive this acute phase in her care.
It was more than that. "It is our professional recommendation to withdraw life sustaining technology."
The silence that followed was deafening. The mother began to uncontrollably sob. Her husband's tears welled up in his eyes. Sound medical evidence corroborates this advice. But still, I had this unbearable weight on my chest that just threatened to suffocate me. Their pain was so palpable that I hope never to fathom what they went through.
They say when a parent dies, we lose our past. When we lose a partner, we lose our present. But when we lose our child, we lose our future.
Since then, I have been numbed. I have been involved not infrequently in such discussions. To cope, I intellectualize things. It really is for the best. I have learned to detach my emotions....at that moment. Once I get out, I feel so spent. I so want to hug my own kids and count myself blessed that I have them.
The death of a child will always be an unwelcome reality, more so a newborn infant. I marvel at the indomitable love parents have, how else can any feeling human being come to terms with saying "hello" and "goodbye" in the same breath?
1 comment:
During my residency, this 5 year old kid that suffered severe brain injury and was on the trach and essentially in a vegetative state turned for the worse during my call. I had to resucitate him and the things I asked for were not there. He didn't technically die on me sicne I was able to transfer him out to acute care but he died after massive resuscitation attempts at acute. I knew he was going to die. The rest of my call, I just was huddled at the corner of the couch and cried my heart out. Would never want to experience that ever again.
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