Mysteries of the Universe

Wow...its been a year since I started this blog. Its gone by so fast. I have not written nearly enough for all that's in my head, taking up space and energy. That is the point of a blog, is it not? So much has happened in the last year. Looking back, I don't know where the time really went. I guess I can stack it all up to life... Wow!!

Needless to say, I kinda checked out of blogging for a couple of months. My apologies to anyone who may read this regularly. I wish there were some great reason or rational why. I would like very much to say that I was off contemplating the mysteries of the universe with Tibetan monks. Or even that I was discovering lost species in the rain forests of south America. But I can not claim such fame. Rather I have been here, in Seattle working like crazy. It seems that there is always a good reason to pick up that extra shift or work some "Christmas spending" OT. However, the most honest answer I can truly give is this. Late last November, I had a very difficult situation at work with a pediatric patient. I took it extremely hard and didn't really know how to process it. I couldn't talk about it for weeks. I tried several times to blog it out...But every time I'd sit down and start writing, it would overwhelm me and I would loose my focus. It was too fresh and too raw. So, I checked out....Out of most everything. I stopped writing, I stopped making art, I stopped training my dogs, I stopped working out...I really checked out. I dove into work, most weeks pulling in 60-80 hours throughout the month of December. I did take 5 days off and go skiing in Canada. Otherwise, its been work, work, work.

So, here I am, a month and a half later...I am exhausted. I am sore; mentally, physically, emotionally, and spiritually. I am unbalanced. But, now I can write about it. Now its time. I think that by doing this, I will finally be in a position to realign. Its time to get healthy. Its time to process and its time to heal.

Right before Thanksgiving I was working on the PICU. We rotate between the Burn ICU and the Pediatric ICU every couple of weeks. I got report that I would be taking a sick baby. I have come to understand this to be an extremely bold but general statement. Obviously any kid admitted to our hospital and our unit is going to be sick. Otherwise they would be on the acute care floor or at the Children's Hospital across town (Children's does not take burns or trauma--hence our unit). So, knowing that these kids are coming to us is the same as knowing they will likely be pretty sick/injured. As much as I don't want to, I have come to accept this fact.

So, I pick up a 6 week old infant. My report was this: Subdural hemorrhage x2 (subdural hemorrhage= blood on the brain) and possible C1-2 fracture (C1-2 is the top joint of the spine, where the backbone meets the base of the skull). Other, possibly older, injuries by scan and film. CPS (child protective services) is involved. Right away I know this baby is ill. Kids this little don't just "break their necks"... They are extremely flexible (think about how they have been living for 9 months, all folded up and squished during pregnancy)... It takes a tremendous amount of force to break a baby's neck. I say a silent prayer. It was obvious, just from looking at his brain scan that he'd been shaken. This baby has blood in his brain in two places, in the front by the forehead and in the rear just below the crown. I think I was crying on the inside long before I ever laid eyes on him. This baby wasn't even 2 months old... and already he had been abused in such a way it would be amazing if he'd survive, let alone recover.

When I received the baby, he was lethargic and weak. He wasn't moving his left side. We had to intubate him to maintain his breathing. Even the simplest responses were lacking. He was so sick. He didn't move when we poked him for blood. He didn't respond to touch or voice. I doubt he even knew how to cry. Just the thought of that made me cry for him all the more. He had bruises on his ribs, head, and arms. Tubes and wires came and went everywhere. He was too small to put a spine collar on. They don't come that small. We had to use a rolled up pillowcase to stabilize his delicate neck. His brain scans showed he was continuing to swell. Fortunately, babies, unlike most people, have the capacity to swell in the brain. Their skulls are not solid yet, so they can expand. For this child, it was most likely the only thing keeping him alive. He continued to decompensate in the PICU. We had trouble ventilating him. His brain wasn't healing. He wasn't responding as we all wanted, and needed, him to. All he could do was stare, with big brown innocent eyes. It felt like he was screaming at me, begging me to help him, pleading with me to make his pain go away. His expression of lost innocence was almost more than I could stand as a nurse. I have never felt more helpless or more useless, than I did caring for this baby. I could do nothing but stroke his immaculate face and hold his tiny hand.

I'm not sure what made me have such an emotionally charged response. I have been trying to figure that out for nearly two months. We see the saddest of the sad circumstances every day. We've all certainly dealt with worse things. But for some reason, I took particular exception to this baby. I think the worst part, for me, is just not being able to understand how anyone, especially a parent, could ever do this to a child. It makes me angry beyond explanation. The selfishness and complete disregard for the most fragile, the most virtuous, fragment of humanity does nothing less than disgust me. I have a hard time trying to wrap my head around it, even now. On another level, all I wanted to do was protect and help this child. I couldn't even hold him and show him that he was safe. It broke my heart to know that in order to help him I had to cause him pain, above and beyond what he had already endured. On some level, I felt like a collateral hypocrite. With all the intensity of my mixed emotions, I think the most riveting one was love. Undeniable and raw love. If I could have, I would have taken that baby home with me. I am in no positon to have a child at this point in my life, but I know that as unprepared and unskilled as I may be, I could have done a better job-- 10,000 times over.

Its going to take me a long time to sort through the emotions of this case. I guess we all have that one that just gets us. In talking to my senior nurses, they all have at least one, if not several stories just like mine. We eventually had to transfer the baby to Children's Hospital. We were unable to get his swelling under control nor could we ventilate him properly. He did not have a good prognosis. His long term care was better managed at the Children's Hospital.

Unfortunately, I don't know what happened to him. I still think of him often, and wonder how he is doing. I think that's the hardest part in all of this, the not knowing. I have no closure. Nothing is for sure. All I can hope is that he did recover fully. All I can wish is that he went home with someone who will do nothing less than devour him with love...