Thursday, January 04, 2007

Non-Knitting Post...

So go ahead and skip right over it. I just need an outlet right now.

I lost a patient today. It isn't the first patient who has died since I started my internship, and it certainly isn't the first since I started med school, but it's hit me the hardest. L was born at 24 weeks and weighed less than 700 grams. It was my first week of residency and I was learning my way around the NICU and the hospital. He was right at the cusp age wise when it's really up to parents whether or not to revive a neonate. His parents are young, unmarried, and fairly uneducated. The neonatologist on call spent a lot of time before the delivery trying to explain the possible outcomes for their child so they could make an informed decision. They decided to do everything available to rescucitate L. During my month in the NICU we fought to keep L hydrated. Being so small and with skin so thin, he lost a lot of water to the air. He was constantly losing weight. He was on a ventilator, under lights because of jaundice, getting IV nutrition because he was too young to eat. He had to go to Boston for heart surgery, but came back to us within a few days. By the end of the month L was off the ventilator and finally gaining weight. His parents were there every day to spend time with him, but never seemed to really understand what we were doing. After I left the NICU I would pass them in the halls and they would tell me how L was doing. I would talk with the residents who had taken over his care and hear about the progress he was making. We started calling him our "star baby" because he never caused any trouble. He was growing like he should, weaning off oxygen, increasing his feeds. Mom and dad started asking about when he would be ready to go home and were shopping for a car seat. By late December L didn't need to be in the NICU anymore. He was transferred to a rehab facility where he continued getting IV nutrition until he could take maximum feeds. In a little more than a week things turned around. He wasn't tolerating feeds and had bloody stools. His blood pressure was low. He was sent back to the hospital and admitted to the PICU. The doctors on call suspected infection and started him on antibiotics. His blood pressure and heart rate kept falling even with medicines to keep them up. After 24 hours of fighting to keep him alive, his parents agreed to stop aggressive treatment. He died in his mom's arms. Tonight, a prayer for baby L and his parents.

12 Comments:

At 12:10 AM, Blogger Kaitie Tee said...

How terrible. :-(

 
At 12:20 AM, Anonymous Beth said...

And a prayer for you, too, Gina. I'm so sorry.

 
At 4:44 AM, Blogger Life's a Stitch said...

That family is so fortunate to have had a medical person who cares so much. More prayers for you, too,
Li

 
At 8:59 AM, Blogger YogaGardenGirl said...

I'm so sorry! Many healing thoughts your way....

 
At 12:47 PM, Blogger Susan said...

Oh, Gina, that's so hard. I'm glad that you honored baby L by writing this post about him, and I'm glad that he had you to care for him. Lots of love to you and his family.

 
At 6:24 PM, Blogger --Deb said...

Poor, poor baby L . . . that sounds heartbreaking for all concerned . . .

 
At 8:58 PM, Blogger Leslie said...

I am so sorry. How blessed that precious little one was to have you and the others caring for him during his short life.

 
At 1:32 AM, Blogger Theresa said...

I'm not sure this is ever going to get easier. But maybe we will learn how to cope better. Hang in there.

 
At 5:07 PM, Blogger Brvfan said...

My heart goes out to the family

Debby

 
At 1:23 PM, Blogger Katie said...

I have never understood while children have to die. My SS teacher said that Heaven would be a lonely place without children's laughter, but still. My heart breaks a little every time I hear a story like this. I cried just this morning over an obit for a 6-year old in the paper. I will be irreparably broken if anything ever happens to one of my children, even if I know I will see them again one day. It won't make up for the loss in this lifetime.

I'm sorry this happened. It has to be the hardest part of being a doctor.

 
At 11:55 AM, Blogger Kessa said...

It's so hard to have a patient die, especially a child.z Prayers for you, Baby L and his family.

 
At 1:56 PM, Blogger Lorette said...

It is hard to have patients die, no matter what their age or circumstance. I'm sorry to say that it doesn't get any easier, even after 25 years of practice. I'll say a few prayers for you as well.

 

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