Last night was one of the hardest I've had since coming to med school. Around 2:30 am we got the call that an infant was coming in "full code," meaning without any heartbeat and not breathing. The baby got there, a two month old, still wearing his blue striped pajamas his mother had dressed him in as she put him to bed. He had a dirty diaper. He had been sick recently with a virus that causes respiratory problems, but in a full-term otherwise healthy baby, it shouldn't cause this. His parents put him to bed around 10, and his mom checked on him at 11, but when his dad came in around 2:30, he wasn't breathing.
The doctor intubated him, and the nurses started IVs and began to push fluids in, hoping that would increase the volume of his blood and help recuscitate him. They gave him epinephrine, a medicine to help start his heart, and continued doing CPR. The alarms on the monitor kept going off because his heart wasn't beating. His skin looked pale in comparison to his dark brown hair and brown eyes that were partially open. You could tell he was gone already. We continued trying to resuscitate him with more medicine and CPR. Finally, the doctor asked everyone to stop as he listened one more time for a heart beat. It wasn't there, and then a nurse listened again, just to make sure. I felt his small foot, hoping to feel a heartbeat. It was cold and pale. The nurses then started to clean him up and wrapped him in a thin striped blanket before his parents came in. The doctor and chaplain went out and brought his family in. His mother looked so young - she could not have been older than me. I do not think I have ever seen such raw grief as I saw on her face and in the crying face of her husband as they entered the room.
I have had a few patients die this year already, probably more than many students. But this was awful. No matter when death comes, something about it just feels wrong. This is not supposed to happen. But when a child dies, an infant whose life just began, there is something that feels even more awful. Since this is my chosen profession, I am sure I will see terrible things like this all through my career. I don't think I will ever get used to it. And I do not think I will ever forget how his tiny foot lay against the stretcher. Or how it made me long for heaven.