Truths Unveiled - By Kimberly Alan Page 0,75
him tell the man. There was something in his tone that made the suggestion non-negotiable.
Pam sighed with relief. At the same time, she felt for the child’s parents. Their grief ripped right through her. She blocked it out, keeping her attention on the child. The small face had now turned ashen, causing Pam’s fear to become a reality. Anaphylaxis had two phases. First, it closed the airway until the victim couldn’t breathe. Then it dilated all the blood vessels, causing the blood pressure to drop to dangerously low levels. Pam secured the airway with the tube but she still couldn’t get the child’s blood pressure back up.
“Try the Epi again.” Pam instructed, fighting to keep calm. “Someone hang me a dopamine drip.”
“I’ll get that!” Tom interjected, returning to the room. He helped a nurse set it up. “What’s the status?”
“Airway secure. Oxygen saturation is fair, but I can’t get her BP up. The heart rate is racing too fast.” Pam knew giving too much Epi could worsen the condition, but she had no alternative. She needed the drug’s blood pressure-increasing effects.
“Doctor!” the nurse exclaimed. “She’s in fibrillation!”
Working feverishly, Pam refused to give up. It was so hard to imagine how a simple bee sting could have such a terrible result. “Charge the paddles! Let’s defibrillate!” she directed. At the same time, she prayed. For the child, her family, and for herself. Please let me help her, God. Don’t take her.
The combination of low blood pressure and a rapid heart rate caused the child’s heart to stop beating. Instead, it just quivered like a Jell-O mold. The only way to get it started again was to shock it.
Pam applied the paddles to the small chest three times, in succession. It didn’t work. “Start CPR!” her voice cracked.
Everyone focused on the heart monitor, willing it to show a normal beat. Drugs, shocks, CPR. They repeated the routine over and over again.
The heart monitor went from a flurry of activity to a straight, flat line. Beads of perspiration soaked Pam’s head. She knew it was time. The nurses knew it was time. Tom knew it, too. “Does anybody have any ideas?”
Silence screamed through the four corners of the room. They had done everything they could. It just didn’t work.
“Stop CPR,” Pam relented, fighting to keep her voice steady. She looked at her watch. “Time of death… 11:45 a.m.”
For a moment, the room stilled. Then everyone switched into cleanup mode. Nurses and aides started bustling around picking up the mess they’d created. They unplugged IVs and shut off the heart monitor. Only an occasional whisper could be heard.
Pam had lost patients before. Many of them. That was the nature of emergency medicine. Not everyone could be saved. Still, she replayed the steps she’d taken in her mind over and over again.
Pam found textbook cases, like this one, the worst. Most medical procedures have a chronological list of steps. If the doctor follows those steps, everything should work out fine. But it doesn’t always happen that way. Sometimes, no matter what she did, it just didn’t work.
She’d also learned early on that the end result left scars that lasted forever. While she repeatedly second-guessed herself, the patient’s family mourned their loss. Eventually, in many cases, that mourning turned into blaming her.
“Do you want me to go with you?”
Pam knew what Tom was referring to. She had to break the news to the deceased child’s parents. They would want to hear it from the doctor in charge. Tom’s offer to share that horrible burden made her remember again why she loved him. And always would. It took everything in her being to turn him down.
Avoiding his eyes, she shook her head. “Thanks, but its okay.” Quickly, she walked past him, determined not to let him see her tears. But inside, her heart cried out: “This is why people marry, you idiot! To share the bad, along with the good. To strengthen each other. To bask in the successes and provide a safe haven when life pulls the rug out from under you. Tom just offered that to you. Be thankful. And stop being so selfish. He needs that same understanding from you!”
Pam tuned out the voice and went to meet the child’s parents. The conversation did not go well. The only thing she could offer them was prayer, which they were not ready to accept. Now numb and yet overflowing with anguish for them and herself, she sought the refuge of her new office.
Seated at her