too young

Warning: This is not a happy story.

Although I see tragic things on a pretty regular basis at my job, I haven't lost sleep over a patient for a good 5 years or so. Until this week. On Monday I had a particularly difficult day. I will spare you all the details. First, because there are too many details to relay and two, it's too difficult to put all of the details into normal language. I'll just give you some highlights. The patient was a 21 year old woman. She came to hospital in the morning to the Emergency Room. She lost the ability to breathe properly around 1 in the afternoon needing to have a breathing tube put in. She came to the ICU around 4. She was dead at 815 in the evening after 5 cardiac arrests in 45 minutes. I walked out of work at 840 in a bit of a daze. The worst part of all of this was her family. These poor people brought their sick daughter to the hospital probably thinking she needed some antibiotics and a few short hours later she was gone. I can barely wrap my head around the flurry of activity. How on earth will these people cope? I have stood by many people as their loved ones die. Usually I have some semblance of a relationship with them. I had not even met most of these people and I certainly don't remember their names. Yet I ushered them into the room, "You must come in now. Quickly. Please, can you walk a little faster. We don't have much time. I want you to be able to say goodbye." We did CPR and bagged oxygen into her lungs so the she was 'alive' enough for her family to say goodbye. They cried and looked at us in disbelief. Our eyes got watery and our chests got heavy. And after a few minutes the room got very quiet. Nurses moved quietly but quickly to turn off machines so they wouldn't alarm. The Respiratory Therapist removed the bag from the tube going into her lungs. The doctor said, "we're done", then looked at the family and said, "I'm so sorry." They continued to cry.

Yesterday I had a long conversation with the doctor because I have relived this situation over and over as I try to fall asleep at night. Bottom line is she was incredibly sick before she arrived at hospital. Nothing could have been done differently to change the outcome. And intrinsically I know this. However, the knowledge doesn't help the hurt. It just explains it.

The best thing I can do is remember the times when we worked our asses off and the outcome was gloriously different. The mother of twins who nearly bled to death but didn't. The 15 year old who should be horrendously brain damaged but isn't. The father who was smoked by a car and essentially died twice who brought us a card and chocolates for Christmas this week three years after he was discharged from the hospital. The list goes on and on. That is why it is worth not eating for hours at a time or peeing until you just can't hold it any longer. That is why it is worth staying up all night on a regular basis. Those few moments when a former patient comes to visit and you can think, "I was a small part of that." What a privilege.