Sunday, August 16, 2009

Wall of Saddness

A 22 yo male arrived via EMS after being in a head on collision at highway speed. There were already 2 fatalities on the scene. According to the paramedics, the patient was found 30 feet away face down with agonal breathing. He was intubated at the scene and brought into the ER as a Level I trauma activation under the code name of Alpha. The patient was in bad shape. He had a large skull defect, cerebral spinal fluid coming out of his right ear, & unequal pupils. These are signs of SEVERE brain injury...but he was being kept alive by residual brain stem function and the ventilator.

After we stablized him, three sets of parents arrived and were put into the family waiting room. I called the chaplain because none of the parents knew about the fatalities. We had no way to identify our patient besides his personal belongings. Our patient, the last alive and barely holding on, had a unique belt on.

I went into the family room to talk to the parents. I said "I am sorry to break the bad news but we had two deaths at the scene. The one survivor is here and is in very critical condition."

All I could hear was screaming and sadness. One family member asked, "Who is the young man alive?" I said, "Sir, we have no way to identify him except that he has a unique belt on." Then one hopeful set of parents started crying and said "Does it have a nickname and silver trim?" I said, "Yes." The parents then shouted "That's out son!"

The other parents were crying in agony. It was probably the worst night of my medical career. Trying to maintain composureI said, "You can come back to see him in 5 minutes, but he is in critical conditon with a serious brain injury."
The parents soon came back and identified him. Unfortunately the CT Scan illustrated irreversible brain injury with a cervical spine fracture. Again, I had to break the sad news to the family.

With more strength and courage than I could ever imagine, the mother said "I want to donate his organs so someone else can live. He wouldn't want to live like this." I was shocked b/c so far in my career, I've seen most make end of life decisions that maintain someone on a ventilator, prolonging the inevitable. I made the call to the transplant center and he became an organ donor. I left the hospital that day with a wall around my heart to seperate my emotions from reality.

I eventually forgot about Alpha until I received a letter in the mail one day from the transplant center. It said the following: "Dear Dr. Sensitive, Although Alpha died on June 1, 2008, we were able to harvest his liver, eyes, kidneys, & tendons. Because of your referral, 12 people were either saved or helped by Alpha's tissues. We are extremely grateful, and on behalf of our patients we thank you."

My wall came down and my emotions came back. Thus far I dealt with that night by building a wall, but now Alpha was a real person to me. I went home that night and googled his name. I found out that he was 2 minutes from his house, his girlfriend was following behind him, and she saw the entire accident. I discovered that he had a My Space Page and looked through it. It was strange to see him as a person, and I was saddened that his life was cut so short. However, through his death and his courageous mother, he saved the lives of 12 others.

-Doc Sensitive


Anonymous said...

I am a recipient of a kidney from a woman who died from a major brain bleed. Her family also chose to make those same donor gifts without ever having to put the woman on a ventilator. There are so many courageous families out there. I think of my gift from that woman ever day for the past six years. I thank the family for having the fortitude to know what their daughter would have wanted and did not put their own personal feelings ahead of hers.

TechnoBabe said...

In your line of work, you see and have to deal first hand, with such tragedy and emotions. I personally am not strong enough to do that type of work, but my hubby and I are determined to donate whatever spare parts in our bodies that someone else can use as soon as we stop breathing.

peedee said...

Well done doc. And bless the mother of that boy.

I think the best way for this whole process to work is to make sure you let EVERYONE in your family know your wishes. Talk about it, make them acknowledge and agree to follow thru with your wishes so if the tragedy occurs they can possibly deal with it a little easier.

I've got a 21 year old and although it was not easy to do when she turned 18 we discussed what she wanted me do to if something should happen to her. She chose to donate.

There is no greater gift than that of life.

Dani said...

That's so sad, but the mom was so courageous to make that decision. If only more people would.

DreamingTree said...

Doc Sensitive, you seem to be a very caring person (the name fits...). As a parent, I can only imagine how difficult that decision was for his parents. As a nurse, I wish more had the courage to make that decision.

08armydoc said...

Wow. Thank you for talking about the positives. We always talk about the zebras, the codes, the almost-were, the crashing patients, the "excitement" of medicine, the completely demented 98 year old on a vent and dialyzed whose family won't let go.

Thanks for reminding us of the humanity, and the caring that happens on the other side of the coin.

LivingDeadNurse said...

wow that was a rough nite. i couldn't imagine having to handle that. your a great doc

Anonymous said...

Thanks for sharing this, and a thousand million blessings to the family for making the best come out of this horrible and senseless loss of young life.

As the bumper sticker says:


Pattie, RN

Anonymous said...

I want in your pants so bad right now

Anonymous said...

I am a loyal reader of your blog but I NEVER respond to any posts.
I work for an Organ/Eye and tissue bank, and talk to famiies with overwhelming losses each and every day. You said what I cannot! Thank you so very much!

Bored Mum said...

I've told my family that I wish to be an organ donor should the opportunity arise. But I can only hope that if something similar should happen to one of my children that I can be like the mother in your story and retain my rational thinking to make the decision to allow my child to become an organ donor. That mother is definitely an inspiration.

BTW, my kids are 6 and 9. We have discussed organ / tissue donation and transplants with them and I am fairly sure that they understand enough about it to be comfortable with the idea. It helped that my aunt (whom they never met) needed a heart/lung transplant, but died on the waiting list, so it put a much more personal perspective to the matter.

RainShowers said...

My grandmother received a liver transplant in 1991, giving her five years of life she wouldn't have had otherwise before an unrelated illness took her life.

She's been gone 13 years, but we still talk about the wonderful gift her donor family gave us. Without that liver, she had maybe two months left to live-at most. She got five years, time spent with loved ones, seeing and doing things she never would have been able to do otherwise.

Rhi said...

This post made me cry. Thank you for sharing. I am a bone and tissue donor recipient.

I was an athlete for most of my life and 3 years ago next week, had a severe injury when I came down wrong on a competition trampoline from 20 feet in the air.

I had a torn ACL, MCL, PCL, Patellar tendon, Lateral and Medial meniscus, severe bone avulsion at the base of my MCL, and muscle damage. It felt like I had been in an explosion. My lower half of my leg was attached by the skin and my LCL. I lost feeling and nerve sensitivity in half my leg. While not life threatening, I almost lost my leg because the damage was so extensive. The internal bleeding put me on high risk for blood clots and poor circulation. As someone who had always identified with being an athlete first and foremost, this was devastating. I was told I may not be able to many things again.

It was five months before they could operate. I remember going on the donor list and waiting 2 months for that call that I was next in line. I had been on bed rest and heavy sedation because the pain was so bad. My knee was in a locking brace. I moved back home with my parents and they put a hospital bed in their room for me.

Several bone and tissue grafts later, lots of staples, screws and stitches, I am put back together because of someone's abundantly generous spirit. I'm no longer an athlete, but I'm just grateful I can walk and often find myself taking a distant parking spot so I can. I've never enjoyed riding a bike more in my life, or walking instead of driving quite so much.

I guess the point of my long windedness is, when you mentioned this man donated tendons, it all hit home and made me feel more blessed and grateful than ever. Thank you.

Anonymous said...

I can feel the wall of sadness about which you so eloquently write. In 2003 I lost my brother, only 46, to stroke. We, as a family, decided to avoid heroic useless brain draining surgery, and instead donated his organs. His liver and kidneys saved three other people. My parents were moved by the letter from the Organ Bank about the three people saved by my brother's tragic untimely death. Thanks for telling this story.

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