Trau·ma  Junk· ie  ( 'trau-m&  'j&[ng]-kE) n. Slang
  1. One who has an insatiable interest, devotion or addiction to responding and assisting people with serious injury or shock to the body, as from violence or an accident.

Big Blue Eyes

My first day in the OR practicing intubations was something I had been looking forward to for a long time. The day was going well. I had seen several cases and successfully intubated four people. It was a typically busy Monday for the operating room staff.

Closer to the middle of the afternoon, things started to slow down. I made my way to the breakroom to eat lunch-- leftovers from the night before-- as I heard the pagers go off.

"Prep OR 7 for a trauma!" My anesthesiologist for the day said to one of the scrub techs. "We may get this one. I hope like Hell they make it to OR."

Making it to the OR would mean the patient was still alive. With traumas, it can go either way.

I glanced down at my pager, reading the words on the screen:

911: Level 1 Response-- 4 y/o female, cardiac arrest. CPR in progress. ETA 5 min.

I felt a huge lump form in my throat. My stomach sank. My palms became sweaty.

I made way to the ER, praying the entire time that she would be saved before I got there. Praying the page was somehow a mistake. Hoping, wishing, pleaing, bargaining... anything to save her life.

As the body of a 4-year-old lay limp and lifeless there before me, I'd like to be able to say I was totally caught up in the moment. I'd love...to be able to say that, while performing CPR, I knew nothing but the objective data: Pulseless, apneic, and cool to touch. Asystole without compressions. Cyanotic. Two IV lines established. Size 4.0 ETT, 22 at the lips. Five doses of Epi in. Flail-chest.

But the truth is, when working on a kid, I learned this isn't the case. As much as I'd like to be able to say I was strong and my sole focus were the numbers, the drugs, the vitals, and how many cycles of CPR were given, I made a mistake that day that I always try not to make.

I looked at her innocent face. Her eyes, which were wide open during the entire code, started into me like the deep blue eyes of my own little one who is the same age. For just a brief second, I saw our patient outside at daycare, playing on the playground, laughing and running around freely like kids do so well-- exactly what she was doing shortly before she went down.

I wanted to be able to bring her back more than I've ever wanted to save anyone. I fought like Hell, trying to defy all odds. I begged silently. I prayed. I made amends with God in hopes that this innocent little girl would live to see another day.

I pictured myself in her parent's shoes, and the thought was absolutely horrifying. Just then, they came running down the brightly lit hallway of the emergency department. Security wouldn't let them in the room.

Her young mother was shouting, "Save my baby! Work harder!! Keep trying!" She could barely get a word in without sobbing hysterically. Her husband was trying so hard to console her-- holding her tightly in his arms, whispering something in her ear.

"Janet, let them DO this!" His voice was firm and commanding, but I could hear the pain. He was doing what he knew a husband and father should do. He was trying to stay strong.

I will never forget the screams from the parents or the little one we fought so hard to save. I did compressions for an entire hour, not wanting to let anyone take over.

I reached the point of shear exhaustion. My entire body was sore. I could feel my muscles aching, joints popping. None of that mattered. Eventually, someone grabbed my by the arm and took over. I was too tired to fight them, as much as I wanted to.

I stood in the back of the room and watched them continue to work on her for about another hour. It felt like minutes.

The trauma doc looked up at the clock, and I about wanted to collapse. I knew what was coming. He ordered us to stop CPR and stated the time of death.

Godspeed, little angel. You will be missed.

It wasn't supposed to happen. Her mom and dad kissed her goodbye before she left for school, like any parent would do. It was a normal day, in a normal town, and she was a healthy kid. She didn't deserve to die. It has been on my mind, even weeks later.

I know we did all we could. I do. And pedi codes are never easy. The next one...will be just as bad, just as trying, just as hard. I'll think about it for weeks like I have this one. It's a part of what we do.

We couldn't save her. It was beyond our control. And, as much as we wish she had made it out alive, it doesn't always happen that way.

RIP, babydoll. My heart is with you.

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