Suhaila
your mom had your name picked out before you were even a twinkle in our eye.
You are now three, a bundle of awesome energy, a loving cuddly mouse with your minnie mouse voice. I love you so much!
you love 'Ponthi' and aloo palak. You could eat that every day I'm sure.
You are a wall artist. Your sisters never wrote on the walls or the furniture, the TV screen, my foot my leg, the car. I could go on. The house is definetely marked by your lovely hand.
I have given up trying to clean off every new art project of yours on some random wall that i discover.
And you have a temper.
Yup, like your dad.
You love to pick out your own clothes hate being fed. Love your Naani to bits. And she loves you!
You are definetely mama's girl.
Any time you have a problem, " i want mama". Mama? Mama! And so on.
You already have a sense of humour beyond your years. I am so proud of that.

How we grieve

Pediatric code five minutes out!!!, "its a drowning"  said the burly and efficient nurse that I have known for some years now. That got my heart pounding rightaway. During this time i was trying to have a very technical conversation with another doctor over the phone about a patient with a blood clot in the leg that was apparantly not improving and what to do about it, so I had to let it go.

Pediatric codes and crash deliveries are about the only two things that get my adrenaline up any more
This was a drowning though, a difficult subject for me since my own near brush with it,
My hands went a little cold and tingly and this tightness settled in my chest as well as a cold icy feeling. Everyone put on their stone face, turned off their inner mother/father/sister and got ready with equipment, meds, oxygen, suction. I quickly assigned everyone their roles, and then we waited the longest four minutes ever, for the ambulance to arrive.
The code went as i expected-it was too late. the baby had been down too long.
I brought mom to the room to hold the baby's hand and told her when I stopped the code and pronounced her.
Then came the wail, that awful deep soulful moan of a mother who has lost a piece of herself that will never be replaced,
I cannot ever describe it, just that every one of those rare moments is forever in my memory in all the years of being an ER doctor
It sears itself into your being.
The tears came to my eyes, I did not suppress them, I simply grieved for the mom the baby and  for the family that was going to deal with this.
I walked out of the ER to call my soul mate my best friend my wife. I wanted to break down and sob but I cant, I am the team leader,
My wife's voice on the phone is a constant, it centers me, it pulls me back to my safe place, my home my kids, but
I couldnt reach her. I stood outside the ambulance bay just breathing.
I choked back expressing my grief right there. walked back to the ER into the cloud of death I had just walked out of.
Then i was off to talk to the dad who had no idea why the childs mom had called him to the ER. I broke the news, he cried, sobbed, deeply, passionately with raw emotion that seared me and let his emotions spill out like his lifes blood. He settled, we took him back to see the baby and I did not go back into the room.
I waited to hear from my wife, now i was busy again with more critical patients, so I couldn't talk to her. So we did the next best thing,
Yup. Text.
Thank you text, grieving is so much easier now,
The rest of the shift-a blur.
RIP baby.

Ilaahi

My dearest ilaahi, you have been in our lives for two gorgeous blessed years. A trying time for your mom and I. Mom-busy with residency, overworked, underslept, pregnant with your beautiful sister-vomiting all the time. Every time I look at you though, all those cares, the stresses, melt away. You have a radiant yet impish smile. You are already toilet learned but like to pee on the floor any way. Today, you peed on Suhaila-I am pretty sure it was on purpose. I LOVE the way you sound in your little totli punjabi. I rock you to sleep, your mom lays with you and rubs your back and you sleep. With me, that never works-I HAVE to put you in my lap. Your are somewhat of a picky eater? Very active, mischevious.

You love Caillou. You love to ask 'kee kardey neeou? kee a aithey? Your favorite quotes I might add. Naani loves you so much. When she leaves you tell her 'Naani Kamm tey gaee".

You have a natural giddha step that many aunties would kill for.

We are so blessed to have you in our life.

Love you a ton!

There are people

I saw an elderly couple a few months ago. The patient was an elderly man who was brought in by his wife for evaluation of hallucinations. Very nice, sweet couple. She told me he was talking about seeing 'people' outside the house where they had lived for decades. So I asked-well, are there people there? She replied-well, not always. Well, what do you mean. So she elaborated: Sometimes he sees people when they are not there. Ok, fair enough. I examined and evaluated the man-came up with the diagnosis of dementia. I started talking to the wife about the issues-but she was very fixated on the whole 'people' issue. 

The next thing she said when told her that he is likely demented was "Well what about the people. I know there are people in the house-people that nobody else but the two of us can see and hear. But I KNOW he is seein things when he talks about those people outside! They ain't there!

Aha...one of the other good things in marriage-not just growing old together but getting demented together.

This is ssooo funny

Veryphunny:

Do everything

She was emaciated, starting to develop a bedsore, weighing no more than 90 pounds soaking wet. Age matches her weight within a couple of pounds. "Shes guppyin, doc!" said the nurse helpfully. Just a few gasps away from that celestial finish line that we are all inexorably hurtling towards. Yank! Pulled back just before she breasts the tape by a 7-0 ET tube and a cold steel blade Mac blade down her throat. A few quick breaths with the bag and we are lookin good. Another gomere saved, then 'uh doc, her heart rate is 50 and no pulse now'. Okay, fluids, central line a couple of chest compressions, she is good as new(!).
I am sitting with the concerned grandson. Well, he says, nobody else in the family wants her, so I took her in. She is very sick I said. Me: She may not make it. How aggressive to be with her care? Do everything doc. Me: Does she walk? No. Me:Does she eat? No. Me:What does she do. Lays in bed until somebody turns her.
Excellent. We will do everything to return her to that life of bliss.
Fifteen minutes later, the ICU doc is looking to talk to the family also-nowhere to be found. So, I guess we will do everything.....

This is not supposed to happen

Two days ago a 4 month old baby died in our ER. Apparantly the child was in daycare, put down for a nap. The caretaker checked on the child later and found him blue and unresponsive. I was not involved in the care of the child but stepped into the room several times to offer any help to my partners who were running the code.

It was not a new thing for me really. But, I haven't had to deal with a dying child like this since Saachi was born.

The baby's mother came in later. She looked quite brave as she walked into the room but when she came out, she was wailing and sobbing deeply. A family member was holding her up. That kind of crying is seldom heard in the ER. I could feel it in my chest. Every sob went through me like a knife. It physically hurt my chest. I tried not to look at her but some strange part of me made me look. Here is the strange part. I cant remember her face at all. When I think of this event I just draw a blank when it comes to what the mother looked like.

I am not really sure why I am even writing about this. I dont know that it makes me feel any better. But I have had this urge to get it off my chest-so I did.