Time. It’s a funny thing. It passes by in the blink of an eye, yet in the rear-view mirror, some things seem so far away. As a pediatric resident, I came upon scenarios that I viewed as black and white. As an attending, they seem to be an ethereal misty gray color. The choices behind the mist are numerous and colored by life experiences; both mine and my patient’s experiences.
Kids aren’t supposed to die. They just aren’t. Even in a busy children’s hospital, filled with the sickest children, we’re supposed to be able to save them, but sometimes we can’t. When all medical options have been exhausted it’s not uncommon for the medical staff to speak behind closed doors about trying to get the family ‘to where they need to be’ in terms of understanding the gravity and futility of their situation. These conversations stem from a mixture of compassion, love, and obligation. As physicians, we never want to do more harm than good. We all took the Hippocratic Oath whose main tenant is to ‘First, do no harm’. As it should be, violating the Hippocratic Oath is a hard line in the sand for most doctors. More and more interventions at the end of life can definitely feel like a harsh violation of this Oath.
Early on, I was a participant in those behind closed door conversations and had a rather linear view of what should or shouldn’t be done. It is, without a doubt, our job as physicians to give our families good information and help guide them to a decision. However, what I have learned and what we cannot forget is this:
“… a few weeks seems just a short period of time, insignificant in the face of a lifetime. Yet, when they are spent with someone you love and will lose forever, they represent an eternity. I will not wake up every morning with a piece of myself gone forever. I will never count birthdays that would have been, holidays with an empty seat at the table, or hands I can no longer hold.”
To my colleagues, may I remind you gently, no one wants to see their child suffer and I don’t want to inflict suffering on a child. When the outcome is inevitable, please don’t insinuate that I have not addressed these sensitive issues with my families. I have, to the best of my abilities, and we are all trying to work through it. This is their eternity, so let them have that last kiss on the forehead, that last twirl of a lock of hair, and that last moment where their hearts still beat together.
Death is what makes life meaningful and nudges us to live with intention; it does not make these difficult decisions any easier or less lonely.
#morethanfour #ChildhoodCancer365
For full article go here: On Not Being Ready
