GamecockDoc

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.

posted by GamecockDoc @ 9:54 PM