Traumatic Full Arrest
“Trauamtic full arrest, ETA 5 minutes trauma bay 1”. I feel the usual rush of adrenaline wash over me as I walk to the trauma bay to get ready. I think the story is it’s some penetrating chest wall injury… who will do the chest tube? Will we crack the chest? I’ll set up everything to intubate.
Approximately 6 minutes after, EMS wheel in a mid-twenties male, CPR in progress. I always look at the face of the EMS provider as soon as they come in, it’s a little cheat sheet for me on how bad it’s going to be. They look hollow and focused, shaken- “24 year old male picked up in a residence with a stab wound to the mid-chest after altercation with brother over video game. Low BP in the field, lost pulses en route…”. Wait a minute. Did I hear video game?
He still has no pulses. His GCS is 3. I immediately go to intubate while the trauma team starts to perform a thoracotomy. Intubation successful, first pass, 7.5 ETT, 23 at the lip, bilateral breath sounds, good color change. Left side of chest open, heart delivered, no repairable lacerations noted over pericardium, aorta noted to have fatal laceration, time of death 2354. Chest closed. Trauma team leaves. I run to the next critical medical just called overhead. No time to breath.
Ten minutes later my spectra phone rings, our social worker tells me trauma 1’s mother is here. Given no visitors allowed in the hospital, the social worker and I go outside to the front of the hospital to tell the mother the news. For the first time all day, I’m feeling. I want to cry and vomit and also not do this. I don’t want to change this woman’s life. We walk out to a family of 6, two women next to the mother and three other family members about 20 feet away speaking to each other. I immediately know from the mother’s face, she has no idea. I introduce myself, and ask her to tell me what she knows. She tells me her two sons got into a fight as they were playing video games and one ends up stabbing the other. I was right, she doesn’t know.
In medical training we are taught to not use euphemisms when it comes to death- be direct, avoid words like “passed away” or “no longer with us” because when loved-ones hear this, a part of their brain will desperately hold on to that impossibility. So I started telling her what we did and I ended it with “your son is dead”.
She immediately fell to the ground and let out an almost inhuman sound, as if able to vocalize the sound of death. I don’t think medical training taught me what to do next. So I knelt next to her and sat her down and put my arms around her and her head to my chest on the cold hospital concrete floor entrance, against the cold air, on the night where she lost two sons. I think medical training would have told me this was not my loss and to try to separate myself. And that would be an absolute impossibility. After what felt like an eternity, I left her on the ground with her family and the social worker. I walked back into the hospital and could not hold back the stream of tears. I didn’t have to pretend anymore that what I just experienced was ok. It wasn’t ok. I wasn’t ok. And that was ok.
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Dr. Abedi’s Bio Below
Dr. Sarah Abedi
Dr. Abedi grew up in Santa Monica, CA. Her favorite things include the ocean, all the trees and burritos.
