“When I was on my second ER rotation, we had a bad case, but it actually hit a bunch of us for life (decades ago).
Mom and dad brought in this infant because she wasn’t behaving correctly. Mom came in the ER first, and asked us to be ready for when dad brought the daughter in because she was ‘real sick.’ It actually isn’t uncommon for family to ‘call ahead’ and ask us to be ready for a sick patient. But we’re a trauma center. First, we’re ready all the time, second, we don’t have time to sit around waiting for someone. This was weird because mom came in while dad parked the car with the sick child. Are you kidding?
Dad comes walking in, and the triage nurse hit the code bell immediately. From the door we could see the child was dusky and limp. I grabbed the infant and ran. The trauma bay was 50 feet away. This kid needed oxygen. I literally ran and gave breaths, as the dad said, ‘She had trouble breathing.’ The team swooped her up at the threshold to the trauma bay. I stopped at the door and heard the conversation of the dad being interviewed by the attending:
‘When did she have trouble breathing?’ He yelled at him, having asked at least three times.
‘After I blew smoke in her face…’ He said, crying.
‘What kind of smoke?’ And the room seemed to freeze.
‘Crack’ he said, barely audible.
‘WHAT?’ This was from the respiratory therapist who was bagging the child (breathing for her using a bag valve mask, attached to a tiny endotracheal tube). That was Big-B.
Big-B was this great guy in the hospital. He took time out to grill us on respiratory therapy tips and techniques. It’s a busy level one trauma center. He really didn’t have the time, and certainly didn’t have to, but he always had the bandwidth to help us out. At this point, you couldn’t even see her on the table. She was literally surrounded by team members in a chaotic appearing, but highly orchestrated dance. The attending had the dad by the door. Suddenly, the mother came tearing into the room, chased by a nurse and security.
She was screaming, ‘You said you quit! You said you quit!’ and started trying to hit her husband before security grabbed her.
It was at least 30 minutes before they called it, never getting a pulse. Big-B lunged for the father, yelling the whole time. I thought he got a good hit in before we got him. The cops were already waiting outside the trauma bay.
Big-B was crying, hard. We got him to the ambulance bay, where he said he needed to be alone for a bit. We let him go. We let him go, and I feel like we never got him back. At the time, I felt like I should have gone with him. I know I needed to talk, or rather I needed someone to just listen to me, and I really hadn’t even worked on the case. Big-B was dead six months later. This encounter destroyed him. He was never the same. I was in the ER enough to watch the change.
I think about Big-B a lot. Every time I work with students, or really sick kids. Watch out for your colleagues, folks. Take care of each other, because the alternative is horrible.”
