Friday, February 09, 2024

Have you opened somebody up only to realise that they were beyond saving?

 

Yes, in one of the saddest stories of my career.

I was the surgical resident on-call at a children’s hospital when a young Polish couple arrived to the Emergency Room with their infant son. He had been born perfectly healthy and had been doing beautifully for the first 2 months of his life, but they brought him in because he was not eating much, he had vomited several times, and was now lethargic and not acting as usual.

After a thorough examination and a set of x-rays we concluded that he most likely had been born with something called malrotation, which is a malformation of the membranes that attach the intestine to the back wall of the belly cavity. Normally these membranes hold the intestine in the arrangement that we’re all familiar with. But with malrotation the defective membranes allow the intestine to move and twist too much, which can lead to blockage of the flow of food in them, and most seriously, to blockage of the blood keeping the intestine itself alive.

So we took him to the operating room having explained to the parents that he might have a twist in his intestine that we intended to undo and fix in place so it wouldn’t happen again. This is the kind of operation that pediatric surgeons do routinely, usually leading to a full recovery.

Unfortunately this was not to be one of those routine cases. When we opened up this little boy’s belly every single inch of his intestine was completely black. We untwisted the intestine and held our breath, waiting for the bowel to pink up somewhat but nothing changed. It remained black. Dead.

I somehow still expected to cut it all out since dead intestine ruptures and spreads gut bacteria all over the belly cavity, leading to a life-threatening infection. But in this particular case my boss didn’t see any point in doing that. There was NO viable intestine. At. All. In the midst of my absolute disbelief we closed this little boy’s belly and went to speak to his parents. It was one of the hardest conversations I have ever had with anyone in my life.

We had to inform this young mother that her beautiful little boy who had made it through the 9-month pregnancy and birth and had been perfectly fine for his weeks’ long life was going to die in the next couple of days because there was absolutely nothing we could do to save him. Watching a full life’s worth of dreams, hopes, plans and expectations vaporize out of a mother’s eyes in a matter of seconds as a result of hearing your words is something that changes you forever.

When we brought him back into his mother’s arms he looked perfectly fine. He was gorgeous. He looked like was made out of porcelain. His beautiful face, brain, head, heart, lungs, liver, kidneys, bones, muscles, genes, skin were all perfect and ready to live a long and happy life. He just didn’t have the working intestines he needed to feed. So we had to sit and wait for him to die in his mother’s arms.

Utterly heart-breaking.

What I take from this experience is to always hug your children and tell them that you love them. They are living and breathing miracles, but destiny has no obligation to keep them in our lives.

Life is too short and too fragile to waste it in nonsense in the form of hatred, anger, meanness, cruelty, selfishness, materialism, consumerism, pettiness, greed, jealousy, or violence.

Life is to love and cherish while we can.


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