I remember the night well even though it more than 25 years ago. It was wet. Biblically wet.
The day had been quiet – the usual mix of children attending with asthma, rashes, fevers, and our small unit was a wonderfully friendly place to work and look after families. I was young(er) and had thrown myself into the job with enthusiasm despite the demands of a one-in-three rota as a paediatric SHO, in a small District Hospital, with no resident registrar or consultant, and a maternity unit to cover as well.
Late in the evening a young girl was admitted with breathing troubles. She was known to our unit and had been under the care of a tertiary centre since birth with an undiagnosed condition.
I tried to speak, but no words came
I was worried about her, and equally importantly, her parents were worried too. We carried out the basic preliminary examination and tests but she wasn’t well. As the evening progressed, the rain continued to fall and she showed no signs of improving so I phoned my (locum) consultant at home for advice as our anxieties rose. He was helpful, and we came up with a plan, which I discussed with the family and nursing team.
I don’t know how confident we all felt at this time, but at about 2am we decided to get some rest. I splashed across the car park to the on call room to recharge. I remember drifting off but being woken less than an hour later by the terrifying cry for help of the crash bleep. My heart sank as I sprinted back to the ward, fully aware of what I would be facing.
The next few hours were to be the most challenging of my medical career to date. Within minutes the young girl had been intubated but we had no anaesthetic support or machinery, and I stood at the bedside with her parents, manually bagging her whilst my consultant arrived shortly after to liaise with specialists further afield.
A priest appeared and carried out a baptism ceremony at the bedside. Her parents were an incredible duo and managed to remain calm despite the seemingly surreal goings on. Her condition continued to deteriorate.
There was no happy ending. Dawn broke as the rain eased, and the day staff arrived on the ward
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I remember slumping in to a chair, completely shell-shocked, and my bleep went off again. I answered it and was connected to my wife on an external line.
‘How was your night?’ she asked cheerfully, ‘can’t wait for the theatre tonight’.
I tried to speak, but no words came. Only tears. I turned to a bemused looking nurse for support, and handed her the phone. My own cry for help.
This was my first real lesson in how to deal with families in distress, and manage my own emotional needs as well. I have had many since then, but none as memorable.
Dr Richard Cook is a GP partner in Hurstpierpoint, West Sussex