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My First Patient Death

There are details about that day that I will never forget. It was a rainy night in the beginning of May. There had been a car accident on a busy highway. A truck rear-ended a Mini Cooper, causing it to lose control and veer off the road into an embankment. Two little boys were in the back seat. Once we had the pre-arrival note we all knew it looked bleak. The boys, ages 3 and 5 were en route from the scene. The 3 year old was in critical condition with an open femur fracture, possible internal bleeding, possible head trauma. His trauma bay was the one I had been assigned to. It's funny how multiple traumas work, though. As much as you try to plan for them, you never really can. His 5 year old brother came in first. The medic was on top of the stretcher giving chest compressions, in his bright traffic yellow rain coat. With every movement of his hands, a gush of blood came out of the boy's now very obvious open skull fracture; it was pretty apparent to everyone who saw this how grim the outcome would be. As I waited for the boy's younger brother to arrive, I just watched the trauma team work, paralyzed in disbelief. Chaos ensued: bags of blood being squeezed into his little veins because it was the fastest way we knew how to get him the blood he so desperately needed...three different nurses trying for further IV access, and failing miserably because his veins were devoid of blood...a fourth nurse held towels over his gaping skull, which were already drenched in blood. How could this be happening to such a young, innocent little boy? I remember seeing his lifeless, naked little body drain in color from a sickly pale, to deathly pale. I don't use this term as an exaggeration or figure of speech. Anyone who has seen a patient who has lost over half of their blood contents knows exactly what I mean by this color. I remember seeing the concave rounding to his chest where his heart had previously been beating just hours before, now reduced to fractured bones where people twice his size had applied their full weight to each compression. I remember the physician calling it...and I was so angry. He said "is there anything else we can do? Does anyone else have any ideas? Does anyone protest to calling it?" I wanted to scream "ME!" I wanted to run in there and resume compressions. I wanted this boy to wake up and start crying and asking for his parents and his brother. But I didn't...and he didn't. The doctor was right. Any further work would just have been disrespectful to the boy's already battered body. I watched them pull the curtain and turn out the lights. Just then, I saw the red and white lights pulling into our drive. It was his brother...there was no time for tears.

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