I'm having trouble sleeping these days. It's a bad cycle I get in, I really deep down know I don't want to go to work. It's weird that I don't really get sad when kids die on the unit, I can keep it at a distance, but it still effects me somehow. Even though I'm not balling-on-the-floor sad, I'm still depressed, when I examine why I don't want to go into work it's because my kids are dying and I can't do anything to save them (not just me, none of us can). When did I become a black cloud? I was talking to my interns the other day and when I told them I was a white cloud they laughed (I really thought I was...but they thought I was being sarcastic)...I see it as a badge of honor, being a guy that always seemed to get it a little easier (at least intern year) I felt bad. My compatriots that didn't get it so easy, seemed to be better at their job, and I wondered whether it was the chicken or the egg. Maybe God or Fate or whatever gave the best doctors the hardest patients (I can't explain it, but people definitely attract certain patients) One day I was taking jabs, jokingly, at a friend who is always attracting the shit storms and a much older, wiser doctor standing behind us in the lunch line said, "Rough seas make the good sailors." My friend said, "Ya, if it doesn't kill em."
1. The normal 5 month old girl who fell over and suffocated, brain dead, we withdrew care. The mother screaming as we told her the child was brain dead and gone, it was like up till that time the child was still alive in here eyes and we killed her.
2. The kid I found seizing for >5 hours straight and went into rhabdomyolysis, muscles working so hard they overheat and die. Basically a seizure that long does the same thing to your brain. We withdrew care a day later, till that seizure he was walking and talking.
3. The little girl who was born without half of her spine, no gut innervation, a fatal diagnosis. She was put on hospice and sent home to die in peace.
4. The little boy with a heart defect, he was placed on heart and lung bypass, when he got really sick. Unfortunately his veins clotted severely and he lost all four limbs to gangrene, parents are having a tough time letting him go, but the same clots that destroyed his limbs have pretty much destroyed all the higher brain function (likely). If they want to do everything for him, he needs a 4 limb amputation, a heart transplant, and a tracheotomy. The chances he survives all these surgeries are minuscule and the chance of any quality of life are 0. It's really weird to hope the family lets him die in peace, but sometimes there are worse things than death, he is innocent, does he really deserve this torture? I see him trying to move his lifeless limbs, sometimes that thought catches me off guard and it gets me a little.
I had to write them down, I was trying to think of the children that have died this month and I couldn't remember all of them at first and that made me feel really uneasy, that maybe I wasn't caring enough or something...I don't know. I'm really worn out and I still have a week and a half to go. My last month of PICU doesn't seem to want to go without a fight.
Newbie-Doc
