Wooden

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“Time of death…. 0345.”

I looked around the delivery room. Sniffling. Tears. Hugs all around.

“You two can take the rest of the night off if you like. I know this will be hard to process. I am available to talk if you need it.” The attending’s voice cracked. He ran a hand through his short hair.  

I looked over at my fellow student. She was sobbing.

Someone came over to the warmer and covered up the little body with a blanket. Mom had been wheeled out while we were still working on the baby once the mad dash for the emergency C-section was over. 

She didn’t know. Yet.

I stepped back and felt my feet crunch into debris. I looked down feeling numb. The floor was littered with the trash from the resuscitation attempt.

Not sure what to do, I stood off to the side, observing the aftermath, the grieving of the staff as they cleaned the room and readied it for the next patient. How many had already died here? How many more would die?

What was I supposed to feel?

Everyone ignored me. I was an intruder, not part of the core family. I was just passing through, one of the dozens of medical students that would come and go this year. I was nothing in the grand scheme of things. So I left. 

As I passed the recovery area I caught a glimpse of the pediatric attending standing next to the mother, holding her hand.

“I am so sorry. We worked on him for over an hour but just could not bring him back.”

The most terrible sob/groan I had ever heard emanated from her lips as she double over in grief. Goosebumps rose up on my arms. I felt some sadness for her.

I kept walking.

I found an empty room on the OB floor and positioned the standard issue rocking chair by the window. I sat in it in the dark and rocked, looking out at the city lights from the tenth floor. 

Why couldn’t I feel something for this baby? 

I felt nothing. Nothing! I felt compassion for his mother, but I could not actually mourn him. 

Eventually, I worked myself up into some tears, grieving the monster that I clearly was. I felt terrible shame. 

Good, at least my eyes will look red.

I sat there and rocked until the sun started peeking up over the horizon. Then it was time for AM rounds on the floor. I checked my face in the mirror over the sink, squared my shoulders, and headed off to the nursery. Self pity was stupid. This wasn’t about me, after all…

Thanks to Jane from Out of The Rabbit Hole again for asking the question: Have you lost a patient to death? How did you deal with it? This was my first pediatric death. I take it out and examine it every now and then as I still marvel at the fact that I felt nothing at the time. Typically when someone dies on my watch, I vary around a mixture of guilt and sadness. Guilt, even though it was not my fault. I remember the faces, even though I don’t remember the names. The suffering. The diagnosis. But mainly the faces.

This was Black and White Challenge Day #2. I nominate John Callaghan. Your mission, should you choose to accept it, is to post a black and white photo and your own nominee every day for five days.

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104 thoughts on “Wooden

  1. Wow, I don’t have words to even comment. We never think about this as part of the training, but eventually every doctor has to face it. I don’t think I could deal with a profession where that was part of the job.

    Liked by 2 people

  2. It is difficult to know what we should feel when someone dies. My first death was an elderly patient, and although she had lead a full life I was still saddened by her death. I did not cry though. I have cried since then, when one of the nurses tenderly said ‘God Bless’ to a patient just before they died. I just found that so touching as we were the only ones there at the time as there was no family present.

    Liked by 1 person

  3. Powerful post. In your lifetime I guess you will see so much sorrow mixed with joy and finding that balance to the survive loss must be essential to keep your sanity. Your posts are always amazing. Thanks for sharing.

    Liked by 2 people

  4. Lord, that must be hard Victo. The baby would have died if the doctors had not been there (i.e. 100 years ago).Perhaps in another 100 years babies like that will be able to be saved. Meanwhile someone has to try to save them today – as emotionally difficult as that is for humans. I couldn’t do that job and I am glad that there those who can. My hat is off to them.(and you)

    Liked by 1 person

  5. I suspect you were simply in shock at seeing your first death, and you were young – how many young people truly grasp the meaning of death? I think I would have reacted much the same way that you did. Then. Now, of course, I would react a lot differently.

    Liked by 3 people

  6. The first patient I lost was to cancer. I worked in a small hospital and the staff was very caring and they knew that I felt bad. They gave me time to reflect. Another of my patients was in her ninties and she just went to sleep. She looked so peaceful. I sat with her and held her hand. It was a good experience.
    Leslie

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      • This woman had lived a long and full life. Her son came in just after it happened and I think he was glad that someone was there for her when she passed.
        Leslie

        Liked by 2 people

      • i had a boss who had been a palliative care nurse for two decades before changing jobs because of back problems. She and I used to have long conversations about what she got from palliative care (it seems so sad to me) and she said precisely what you just did swo8- that it was an honor for her to help people live their last days with grace and be present to comfort them when they died. She too said it was a very peaceful, right feeling when someone passed on.

        Liked by 1 person

  7. Very powerful post. I found it touching that you were so upset about not being upset. I imagine it must have been somewhat of a shock though, and you were a student. I imagine if the baby had been a patient you had known, you would have been more upset. Or if you had been a mother at the time and imagined how you would have felt, perhaps you would have been more upset. I suppose no one ever knows how he or she will react. Thank you for sharing.

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  8. The reason I resonated to this post is because you’re so HONEST (as you are with all of your posts). That makes you, your doctoring, and your ‘being’ so much more real and believable. And it makes me like you that much more (even though I don’t know you, in person). When I was young, I cried easily – at movies, at sad situations, at my dog if he ran away and I didn’t know where he was. But now, after family deaths, the end of friendships, incredible births, divorce, love and joy, I rarely cry. I think I’ve steadied myself, secured my feelings, placed borders around the hurt and pain, so that I can be more useful to myself and others when ‘bad things happen.’ That’s what I think you did when that infant died. And perhaps, you are a better doctor for that ability.

    Liked by 2 people

  9. I may be at my most vulnerable when I’m sharing someone’s grieving experience. My feelings aren’t for the baby at all, but for the mother. The mother who carried that baby, and all her hope, for THAT. The mother who will have everyone look at her with pity and knowing, except those she’ll actually have to tell. That is brutal. Absolutely brutal.

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  10. Sounds to me that at the time, you felt worried about not having feelings for the dead baby. Maybe you needed to know if you were “normal”. Of course you weren’t normal. Nobody is. We all react differently to different things. I find that as I get older I am hardly ever bothered by death. Death is just a natural part of life. And maybe that was something you’d already come to understand, even as young as you were. I liked this post, because it’s refreshing to me when I learn of someone who doesn’t follow or fake a stereotype.

    Liked by 2 people

    • I have actually been around death from a very young age. One of my friends died when we were five from a neuro degenerative disorder and it was on some level a blessing for her. So I was sad but also happy for her. Death something that always has to be feared or grieved which may be something odd for a five year old to understand. I did think about her and her funeral that night. Death and I have a complicated relationship….

      Liked by 1 person

  11. Wow. Thank you for sharing this. And for your honesty. I know for me, that sometimes, something is just so intense or overwhelming that the only way to cope, to breathe, to take even a step, is to shut down some. To go numb in the moment. I can’t even imagine a situation like this though.

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  12. I often shed a tear for a patient I had nursed, some of whom I still occasionally think of many years later. However it was my first encounter with the death of a child which hurt me so much. I was working in A and E as a student in a childrens hospital when an ambulance arrived with a small baby, and a young distraught babysitter. Very shortly after the babies parents and grandparents arrived by car. The baby had died from SIDS. I couldn’t get over it, such a perfect looking baby, gone.
    The ward sister took myself and my fellow student nurse to the morgue later to see it. I didn’t want to go, but she encouraged me to face it, and to mourn and accept that sometimes it is very hard to be a nurse. She sat with us as we cried our hearts out, and then brought us for a cuppa. We continued to work that day but she clucked about us all the time.
    I was lucky to have someone like her to guide me through my first really hard death. It’s not easy, and dealing with family can be heartbreaking, but I know doing it right makes a difference.
    Your post brought back that memory, forgive me for rabitting on.

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  13. Our expectations of our emotions often create the drama whether we want it or not. Good for you being real and honoring your detachment to something you had no control over. Sometimes death is just that…. over. And we move on. It is funny what triggers us. Death in humans does not nearly bother me as much as in animals. I cry sometimes when I see a road-pizza squirrel. I howl at dead cats and doggies especially. I cry when I see trees cut down. I am such pantheist.
    Great post.

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  14. Ok, I’m weird, but… I don’t think it is in the least bit odd that you were detached at this. And you weren’t totally detached. You felt sympathy for the mother.

    You were a student, with all the stress that you’ve written about that. You were most likely concentrating on the JOB, on the medicine, on the anatomy, or whatever. I would assume as doctors, med students, that you get some kind of instruction … whether formal or someone just pulling you aside… on learning TO detach. If you crumple every single time, you’ll be a crap doctor. You’ll also drive yourself insane. Yes, it is bad when professionals totally detach, too.

    I’m rather more surprised with x-number of years of experience behind you that you still are bothered by this. (That has a bitchy tone to it that I don’t intend, but don’t really know how else to say it.) Surely there had to be other instants in which you’ve been detached? This is probably not the highest praise, since the source is me, and well… I’m not the most stable brick in the pile, but you seem perfectly normal to me, then and now.

    Liked by 1 person

  15. I’m no expert….but the ‘no reaction’ almost seems like a self protection.

    Your words here are so incredibly honest and laid bare. I read them and they made sense to me. I don’t know why. I suppose because there must be some reason that it did not impact you at that moment, the way it may have impacted others, or the way it may have impacted you later. Maybe it impacted you exactly the way it was supposed to so you would continue on and become the doctor you are. And from there, become the writer you have become. I feel your writing has given ‘us’ a chance to see, as you say, behind that white coat. You speak eloquently, you speak truthfully, you give us insight we may not otherwise ever have a glimpse of.

    Of course I only know you through your ‘words’ but from your words, I would never describe you as ‘wooden’.

    Liked by 1 person

  16. I don’t know if you’re like me in this, but I don’t/didn’t usually feel anything in the moments when someone dies either. It hits me later on, sometimes much later on.
    What you went through there would have been unbearable, maybe you’re mind was protecting you from that kind of pain.

    Liked by 1 person

  17. My best friend and mom are doctors. My friend’s reaction was exactly the opposite. In time she learnt how to separate emotions from her work – otherwise she’d have collapsed.
    My question in such cases has always been, what if you know the person on the gurney? Even if you didn’t actively perform the treatment… you were there.

    Liked by 1 person

    • I have never had that happen in a crisis situation but lots of friends and colleagues see me as their physician. In a life or death situation I expect I would do what needs to be done but when it was all over, I am certain it would be terribly upsetting. I did put stitches in my son’s chin once and after, when it hit me what I had to do, I shed a few tears.

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  18. Your chosen profession is one where you are allowed to feel anything but in most cases you have to control those emotions and learn to focus on the task at hand. I suppose it’s similar to a soldier who is allowed to feel fear but not allowed to show it. Presumably, the enormous effort required to keep your emotions under wraps does not disappear the moment surgery is over.

    Liked by 1 person

  19. Honestly, it sounds like emotional numbness as self preservation. But then, I’m biased as thats my automatic defense mechanism to deal with emotional overwhelm.

    Liked by 1 person

  20. Don’t you HAVE to be kind of detached? Imagine if every death wrecked you? You’d be good for nothing in no time.

    A bad day at work for me is a document design or print job gone horribly wrong. A typo. The wrong weight of paper was used. Big difference.

    Liked by 1 person

    • True. As a newbie I didn’t realize that though. I really felt as if I should have felt something. Anything. Everyone else was. Or they were putting on an act, which is possible. I am at peace with it now, though.

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  21. Pingback: My Article Read (4-7-2015) | My Daily Musing

  22. You weren’t wooden. Nor a monster, though I’m sure plenty of people have said it before me. That’s what being a doctor means. That’s why people look up to you, to doctors (trust me, some still do). We try our best, we feel a twinge if we fail, then we square our shoulders and try with the next patient. I’d rather go with the surgeon who doesn’t faint at the sight of blood, if you know what I mean. πŸ™‚

    Liked by 1 person

  23. Your response–emotional shutdown–can occur with those exposed to too much negative emotion when young. I’m not saying that is so in your case, but it was true in mine. I did not cry aloud–still do not–nor did I laugh. One cold fish, even for a high-end Aspie. As I healed more, I felt more, and expressed more.

    Agree with all the others: Superior piece of writing.

    Liked by 1 person

  24. I often feel the same way after a failed code or trauma resuscitation. It’s hard to have feelings or emotions over someone that has no connection to us. It doesn’t mean we don’t have the capacity to feel those emotions. Just imagine how hard we work together, as an educated team to do everything we possibly can to save the lives of these people we don’t know. That crunchiness under your feet as you walked away from that baby – that is the evidence that you care.

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  25. i would never want to work in peds, even though people claim “you get to deal with cute kids” all day- not exactly true. there’s something unnatural about tiny hands and bodies having problems or passing away 😦

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  26. Sometimes it’s just good to give yourself time and space alone.

    I’ve never asked my sister-doctor yet about her first patient death. I know she has dealt with a number of them as an emergency medicine doctor…because this was alluded for the first time when my father was slowly dying of prostate cancer last fall. He had an excellent quality of life for last 5 years ..something sis told us early and became more obvious to us.

    Did we ever go to palliative care counselling, etc.? No…things happened in short while and we were getting guidance informally from sister anyway in terms of clarification of near-death symptoms over time. She was the sibling (out of 5, with me only one living in another province) that chose to accompany my father for all his oncology appointments for the last few years and cut some of her hospital work shifts to do this.

    Liked by 1 person

  27. At first, I thought that maybe it was clinical detachment, but you did felt something for the mother.
    I don’t think you’re a wood at all.
    I believe that we are able to feel something, if we let ourselves feel. Because for me, I’m not sure when I learned it, I only know I’ve been doing it since I was a little girl because I was raised by my grandparents. My mom is working out of the country and I don’t know who my father was. Being detach I mean. I told myself to detach myself from the situation. At that time, I’m not even aware what the word detach means, but I did it.
    Then years later, closing my eyes, until I can still picture the first two patient deaths I’ve seen in 2006. I can clearly remember what happen. I’ve let myself feel and at that time, my emotions were raw because my Grandfather died two months ago.
    Then another colleague helped me through it. Since then, that where’s I first heard about clinical detachment.

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