You never forget

You never forget the first time someone dies in your care. At least that's what they tell me tonight.

I arrived in the North only days ago. My time has already been enriching as I greedily accumulate post-residency experience: my first febrile neutropenic patient, my first fibreglass cast, my first Form 1 commitment. I am even getting to the gym and sleeping regular hours. Until tonight.

Figure. Photo by: Aurora Borealis, Joshua Strang, Wikipedia

In the middle of the night a call awakens me: an ambulance is on its way to pick up a baby that is reported to be not breathing. I rush to the hospital to find the child flaccid, unresponsive, apneic, asystolic. My first official code, tonight.

My head drowns in acronyms: PALS, ABCs, ECG, CPR, ETT. The intubation is difficult, and I call in a colleague who has experienced many tonights.

Bag and mask. Compressions. Epinephrine. Atropine. Venous access gained, and lost. Why doesn't this seem real? Why am I not diaphoretic, or worse? Am I calm or indecisive? Despite the fact that the baby's pulse is from our pushing palms, and his breaths from our squeezing hands, the infant is never ours. The look in the nurse's eyes says that the last time the baby was alive was earlier in the evening, at home, tonight.

The adolescent mother comes in, followed by the baby's father and his correctional officer. A former foster mother next. Resuscitation is stopped. Tears, so many tears. “Baby come back! Baby come back!” they plead. But there are no miracles tonight.

Any residual cynicism from years of residency hardship is dissolved by their sorrow, their anguish breaking the looking glass of what had seemed like televised drama.

It is real and I feel raw, tonight.

The coroner and the social worker and the extended family and the back-up nurses and the police constable arrive. We explain and console. Rub backs, clutch shoulders, fill forms tonight.

I walk back to my locum housing. The early morning is long and somber; so many stars in the sky, so heavy the clouds. The lights of the Aurora Borealis starkly contrast the darkness welling inside of me. I cry, inside and out, tonight.

They say you never forget the first time someone dies in your care. I hope I never do.