How do you come back after losing a battle?

During my pediatric surgery training, I could easily point out which was the hardest day for the three fellows that were under training on that specific year. It was late evening when I received a call that one of our patients had coded. I was at home, and the drive usually took me exactly seven minutes.

Due to social reasons, this patient was in the hospital with us for months (at least that is what my memory recalls) prior to the long-awaited operation that would change his life for better, making it impossible not be extremely emotionally attached to that little boy. He underwent prolonged CPR, followed by open chest cardiopulmonary resuscitation, multiple blood transfusions and hours and hours of sincere efforts to try to bring back who was no longer there. I distinctly remember my attending and I closing his chest, crying and talking how we had to clean him completely and dress him, so we could bring his mother to see him. No medical school prepares you for these types of moments.

When you are in the pediatric field, it is always like that. The death of a child never feels like something normal, even when in some cases, due to the nature of the disease, it would be expected; it is still unexpected from the rules of mother nature, unfair and it should not happen. Despite any rationalization or religious beliefs that you might have, it always feel the same. The weight of the thought that you might have contributed to that premature death is a very strong one. This is probably easy to understand, even for those that are not in the medical field. What is not easy to understand is what comes after.

The next day, the alarm clock goes off, and you have to go to work like nothing had happened. Unfortunately, you are not the same. For me, in the day after, besides my own feelings, I had to look at my team, all the nurses who also loved the little boy, talk about it, see and examine 20 other kids that were in the same floor together with their moms, that also knew the little boy and knew that the little boy was no longer there with us. And even when they don’t want to tell me, I can notice in their eyes that they too are scared. Because when death passes around, it makes you think about the ones you love.

But on the same day, you go to the outpatient clinic and see other patients that have not met the little boy. But you remember how much they’ve been through, how sick they were one day, and seeing them thriving and growing well is a reward that no other profession has. That day, this family has no idea the benefit that they brought into that provider. Then you realize that our profession is exactly the essence of life with good and bad days, but it is the passion for what we do what brings us back.

Andrea Bischoff is a colorectal pediatric surgeon.

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