As I sat reviewing the chart, the sirens blaring
outside the windows caught my attention. Whoa, it's busy tonight, I thought.
Glad I'm not in the ED.
A nurse interrupted my thoughts. "They want
you in the emergency department," she said urgently. I glanced around; my
supervising resident was nowhere to be seen. No surprise there, I thought. He'd
been MIA all day, leaving me to do all the charting and patient care.
Frustrated and angry, I retorted, "The
supervising resident does the cardiology consults in the ED. I'm the intern.
"No," she repeated, "They said to
have you come."
"Who are they?" I asked.
"I don't know." She shrugged her
shoulders and walked off.
I stomped down the hall to the elevators, seething.
I can't take any more, I said to myself. God, I'm so tired. Why can't
they just leave me alone? Why do I have to do the resident's work?
The ED was the zoo I expected. Securing the
attention of the overworked ward secretaries, I said, "I'm Dr. Meelhuysen,
from the cardiology service. What patient did you want me to see?"
Three blank faces stared at me. They all verified
that no one had paged anyone from the cardiology service. Overwhelmed by
frustration and anger, I turned to leave.
On the way out, I paused in the doorway to the
cardiac room. My gaze landed on the still figure on the far gurney. Well, it
looks like that guy didn't make it, I thought. My glance then turned to the
frenzied activity at the closer gurney. Why are they coding that baby? I
wondered. He's dead.
Suddenly, I noticed something—a familiar blue
sleeper. No, I thought, it couldn't be. There must have been hundreds of those
blue sleepers sold at Mervyns a few months ago when I'd bought one. But it sure
did look like the sleeper I'd packed for my brother to dress my son Michael in
when he went to bed.
Earlier in the week, my husband had had to leave
unexpectedly on a business trip, so I'd asked my brother and his wife if they
would watch our 2½-month-old. They had agreed, to my great relief. It was the
first time Michael had been cared for by someone other than me or my husband,
and I was glad it was close family.
Thoughts raced through my head. Nothing made sense.
In a daze, I tried to work my way around the code team, attempting
unsuccessfully to sneak peeks at the center of attention. As I wormed my way
around the team, I pelted them with questions, trying to figure out how a baby
would get to the cardiac resuscitation room. "Where are the other
people?" "Was there a bad car accident?" "How did the baby
No one answered me. Maybe there wasn't a car
accident, I reasoned, and was comforted by the thought. Earlier in the evening,
my brother and sister-in-law had brought Michael to the hospital for me to see.
He had looked perfectly normal, healthy, and happy. The only way this could be
my baby, I concluded, was if they had been in a car accident.
If only I could work my way around and see the
face, then I would have that final confirmation that it wasn't my son. After
what seemed an eternity, I finally made it to the head of the code table. But
the face was unrecognizable with all of the tubes and tape and hands flying.
"What's the baby's name?" I finally
"I don't know," replied one of the
doctors crossly. "Would you shut up or leave the room? You're disrupting
the code team."
"I, I, I think it's my baby," I
The code came to a screeching halt as 10 pairs of
eyes stared at me in absolute horror. They all knew me. Then as abruptly as the
code stopped, it started again. One of the nurses told me, "We don't know
anything about the baby. All we know is that the sheriff and a paramedic
responded to a local blue baby call and scooped and raced with the baby here.
When they came running through the doors, we all left the other guy and started
working on the baby." I watched, frozen in place.
Finally, a nurse came in and announced that the
people whose house the baby was picked up at were here. I followed her out of
the room. I had to know.
In moments, the double doors to the hallway swung
open and I stared at the tear-stained faces of my brother and his wife. I
staggered as the meaning of their presence hit me. It took my full concentration
and sheer will just to stay upright.
Voices faded in and out in an ethereal hum. I heard
my brother say, "If it's my fault, I'll kill myself." My focus shifted
to concern for him and his wife. I assured him that it wasn't his fault and that
these things happened. I asked for a quiet place for them, and we were shown to
the empty nurses' lounge. Soon a sheriff joined us. In a daze, I answered his
questions. "No, I didn't suspect any foul play." "No, he'd been
perfectly healthy." "There were no known birth defects."
"He'd been born a little early, but was still considered term."
When I couldn't handle any more questions, I went
and watched the code. In and out I went, pacing back and forth. No one seemed to
notice. No one tried to stop me. Finally, I sat in a chair behind the
secretaries' desks where I could listen, but not watch.
I called my husband, frantically searching for
words. Even though the code team was still going strong, I knew that things were
dismal. Then I called a close friend and a pastor I knew for support. This was
new for me. I was used to providing the comfort, not reaching out for it.
Giving, not receiving. And it felt awkward.
My brain switched back and forth between the
emotional and logical sides. What could have gone wrong? SIDS? A congenital
defect? I grappled with a million random thoughts. The ED attending sat down
across from me, discussing the case as if I were a colleague consulting on it.
"The core body temperature was 91 degrees when the baby arrived."
"We haven't gotten a spontaneous heartbeat yet." "We're
artificially ventilating him." "We've coded him for 50 minutes."
The information streamed in and out as my mind wrestled with the facts.
Left brain: Those numbers aren't compatible with
Right brain: Don't give up; try harder.
Left brain: If he survived, he'd be a vegetable;
there has been too much hypoxic damage.
Right brain: Good grief, why are you telling me all
Left brain. Right brain. Left brain. Right brain.
"What do you want us to do?" the
attending finally asked. "Do you want us to continue? The team is willing
to keep trying because it's your baby."
We discussed the code and the facts of the case as
rationally as I was capable of. Finally, my left brain asked me, "Do you
want to take care of a vegetable for the rest of your life, even if they do get
the heart going again?" And the right brain shrieked, "NO! Don't give
up!" But the words that came out were, "Call the code. Stop the code.
If I can't have him the way he was, I don't want him at all."
Why did I say that? What a self-centered statement!
The ED attending sighed in relief, "I think
that's the right thing to do," he stated and left to stop the code.
I asked for the phone and called my anxious
husband. A half-hour had passed. "It's over," I said, verbalizing what
I'd already known the first time I'd called.
I walked back into the too-quiet code room. It was
empty except for two cold bodies and me. No one bothered me, except the assigned
chaplain who walked in awkwardly and shifted nervously from foot to foot in the
back of the room.
"Touch the baby," he instructed.
"The grief books say it helps in the grief recovery later on."
No, I thought, I don't want to touch my baby. He's
cold and hard, and babies are supposed to be warm and soft.
Dutifully, I touched my son. He was cold and hard
and waxen. It was repulsive.
I asked to be left alone, and the chaplain, who
seemed grateful to be excused, left. I sat there pondering, trying to figure out
something that made sense. I prayed, because that was what I'd been raised to
do. I asked God for a miracle. Silence. I asked God to raise my baby back to
life. I heard a word being uttered. It was "No." Startled, I looked
around the room. No other living person was present. Okay, I accept that, I
thought. Just promise me that someday, you'll explain why.
Suddenly a sense of peace and calm came over me.
How long I sat in the room, I don't know. Eventually the practical side of my
brain woke me up out of my reverie. They're busy; they're going to need to clean
things up, I said to myself. They probably need this room for other patients.
Then came the parade of law enforcement officials.
There were going to be two investigations: a criminal and a coroner's. The words
flew at me and bounced off, landing somewhere else in the room. "Where was
my brother going to be? Where was I going to be?"
Good question, I thought. Where does one go after
losing a son? What does one do after losing a son?
Finally, someone suggested that I go home for the
rest of the night. What do I do with my pagers? I thought. I don't want the
nurses to get mad if I don't answer my pager.
I called my supervising resident. It was now about
2 or 3 in the morning. He seemed irritated to be awakened by my call.
Although I suspected that he'd already been told, I explained that my son had
just died in the ED and that I needed to go home.
"Are you going to take the rest of the night
off?" he asked incredulously, more concerned that he'd have to round on all
the patients without me.
At first, my left-brain almost responded, "Of
course I'm not taking the rest of the night off. I'll stay and help." Then
my right brain kicked in and I got angry. Reluctantly, he agreed to take my code
pager. I made my way up to the resident sleeping quarters and handed it over. He
took it gruffly and shut the door.
Because my family wouldn't let me go home alone, I
spent the rest of the night sitting, unable to sleep, on my sister-in-law's
couch hugging pictures. Morning came ever so slowly. But it came.
I learned a lot about being a person and a
physician that night. I experienced, in a dramatic and personal way, the
intensity of life and death, of grief and suffering. Having a baby changed me a
little. Having a baby die changed me a lot. As I've reflected over the years on
the experience, I have come to be grateful for the personal growth, the lessons
learned, and the insights gained.
- The spiritual quest I embarked on after life
forced me to face the tough questions led me to a real and vital
relationship with God. While life is unpredictable and painful, it is also
enjoyable and real. Not a Christian before Michael's death (by SIDS, as I
later learned), afterward I discovered that God is a faithful friend and
solid anchor in an unsafe world.
- I am grateful that I learned young in life (27)
what my priorities should be. That people are more important than houses,
fancy cars, and bank accounts. Too many individuals get to the end of life
and wish they'd spent more time with their loved ones. I am determined to
live as regret-free as possible, although I often fall short of that goal.
- I became a more compassionate and caring
physician. I became a real human to my patients, not just a diagnostic
clinician. I understood as never before that patients are whole beings with
spiritual, mental, emotional, social, and physical needs. And often those
needs are interrelated and I need to address them all.
- I learned to cherish my three subsequent sons
and their unique and special gifts. It is my prayer that I never take them
- It also became a passion for me to advocate for
those who struggle. Because of my deep personal pain, I now invest
tremendous amounts of time and energy making lives better for those
struggling with learning problems and other cognitive disadvantages.
- I came to realize that I needed to treat
families and patients with sensitivity and not to ask families to make
clinical decisions that could potentially haunt them for the rest of their
lives. I don't ask families to make life-and-death decisions under duress.
What they need to know is that we're doing everything humanly possible that
doesn't violate their loved-one's wishes and desires. When to stop a code is
not a decision a family should make. It is a medical decision.
- And lastly, I discovered that crises do not make
us; they reveal us. The revelation of Michael's death caused me to take a
long honest look at my life and begin to make changes. It is a journey of
personal growth I continue to this day.