Day 208, There are many ways of describing it, some call it Sod’s Law, others call it Murphy’s law while still others will refer to it as simply speaking too soon, but however you describe it I have fallen afoul of it in spectacular fashion. The last two months on paediatrics has been tough but rewarding having had no losses in that time. I quipped recently that I was going for a spotless record, a day later fate wanted to punish my vanity.
It was a 29 day old baby who had come in with fits and a fever that challenged my resolve. Initially he was deceptive, made me think that as I’d made the diagnosis of bacterial meningitis I would give the treatment and it would be plain sailing. Two days on the ward and he started to wobble, his temperatures wouldn’t settle, his blood sugars were all over the place and his kidneys were packing up. I managed it during the day and the on call was fire fighting all night long.
The following morning we noticed it had started to bleed. It was succumbing to the overwhelming infection and soon it would be over. Feeling guilty for tempting fate I decided that if the child was going to die, it wouldn’t be through a lack of effort, not on my watch. Giving it almost intensive care I kept ringing round the various referral hospitals to see if I could get anyone to take the child. After several hours of negotiating it was agreed that I could transfer him.
At every turn the baby was fighting me. If I managed to stop the bleeding, his IV line would blow and prevent me correcting the shock. If I managed to find a vein and push fluids, he would start fitting. I tried not to take this as a sign, and arranged for an airlift, though the helicopter was unavailable meaning he had to travel 50 minutes down the road to catch a plane. I left for the evening knowing I’d arranged the transfer and at least I’ve given him a shot. I knew he wouldn’t be on the ward this morning, one way or another this child wouldn’t be around.
As I went to work this morning the paramedics came up and explained what had transpired. En route to the plane the ambulance had gotten stuck in the sand. The plane had subsequently departed sans baby. A second ambulance sent to retrieve the vehicle had also gotten stuck. The baby was somehow taken to a local hospital to be monitored and eventually a functional ambulance transported the baby in the wee hours of the morning. As is usual in such circumstances, the baby finally gave up en route. And despite resuscitation he died in the back of an ambulance.
Recently one of my colleagues remarked how we see miracles happening at the hospital every day. Though I admire the positivity, today it feels as if the only miracle is that more don’t share the same fate.
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