March is a month of contradiction — the “in like a lion, out like a lamb” thing and all. We see in it the ups and downs of “March Madness” and the rogue winter storms covering freshly sprung daffodils; it is also evident in the types of patients presenting to trauma centers. March, in fact, holds in my remembrance one of my most tragic patients. A tragedy that continues to effect me both as a nurse and a father.
“FlightMed en route with a pediatric trauma code. Victim is 3 months old status post restrained rear seat passenger MVC with tractor trailer. Pediatric Advance Life Support measures in progress. 15 minutes to rooftop”
Our pediatric trauma team activates and prepares for the infant’s arrival. Personnel assemble, roles are delegated and supplies are gathered. I’m the nurse manager of this team of experts. My role is logistics and team support. There is no doubt that emotions will run high. I know I’m already on edge thinking about my three month old daughter at home. A quick call confirms my wife and daughter are safe.
15 minutes quickly pass and the flight team arrives to the bay. A fast moving, unexpected snow squall blanketed vehicles traveling along a highway; a crisp, sunny March afternoon suddenly was reduced to zero visibility. The minivan carrying our delicate patient got caught between two jack-knifing tractor trailers. The truck in the rear overturned and caught the rear corner of the car. This action catapulted the vehicle into the forward truck, wedging it beneath its trailer.
First responders find the child properly secured in her seat. The portion of the car where they find the child remains the only intact section; she is in a seemingly perfect bubble of safety. Yet, the baby is unresponsive, apneic and bradycardia. CPR is immediately initiated but she then loses her heart rate altogether. Medics arrive, intubate her, establish IV access and have fleeting success in restoring vital signs. We learn the mother is also critically injured and being resuscitated at an adult trauma center just miles down the road from ours. Unlike the horrific description of the mother’s injuries, the baby before us is exquisitely beautiful; there is no evidence of traumatic injury. Minus the IV and the ET tube, she looks like the sleeping daughter I left on my way out the door that morning.
PALS efforts continue on arrival but fail to produce sustainable results. We keep going knowing the father is on his way. The care we deliver is proving futile but we continue for a hour and a half not wanting her to “die” without someone who loves her. Unfortunately, he becomes snarled in the traffic jam created by the accident. He is eventually able to get the help of a state trooper but arrives an hour after his daughter is pronounced.
He is greeted by a red-eyed, moist faced team; we bring him to see his daughter. His stare of disbelief devolves into uncontrollable sobs of despair. We surround him taking turns to hug him. He then turns back to his daughter lying in the bassinet and kisses her forehead. Then, in a panic, says, “I’ve got to get to my wife!” The state trooper tells him he’ll provide an escort and they quickly exit. The nurses involved in her care then provide post-mortem care.
I make my way home several hours later. I trudge the mile from the train station. I’m in a zombie-like state barely noticing the dusting of snow and the 25 mph winds. My wife opens the door on my arrival; she is holding our 3-month old daughter Caroline. Seeing her breaks me down. I calm as I envelop both of them in my arms.
A week later, the group of trauma nurses that provided care for our beloved patient visit the injured mom. She is a shell of a woman with deep sunken, eccymotic eyes. An external fixator scaffolds her leg. The bulge of her hospital gown tells me a similar appliance is holding her pelvis together. We introduce ourselves and thank her for accepting our invitation to visit. We tell her about her daughter’s last minutes and speak of the love we poured into her resuscitation. She starts crying and thanks us for caring for her daughter. She tells us how important it was for her to meet us and to know her daughter wasn’t alone. Tears now flow from all of us.
Jill, our most veteran and hard-core ER nurse, then pulls out a small box and gives it to the mother. She opens it to reveal a memorial pin – a golden cherub. The mother immediately attaches the pin to her gown, over her heart. This becomes one of the saddest, most beautiful moments of my career. It also transforms my thinking as a father.
It is so easy to take everything and anything for granted:
Birthdays come and go.
First days of school become routine.
Getting a solo in the orchestra loses it shine.
Going to prom in a dress that makes you realize she’s not your little girl anymore.
Heading off to college to the great unknown.
Et cetera, et cetera, et cetera…
Do not let the March of time roll on. Cherish these times, hug with a tighter squeeze, make tears come from laughter more than sorrow, be present in life’s smallest moments
Take it from this trauma nurse, tomorrow is never promised!
Also published at www.dadjusthappened.com