The child was screaming, screaming bloody murder and crying her heart out.
For the past five months, she'd been told that her mom was on a business trip. A really long business trip to a land far far away, so far there wasn't any access to telephones. She hadn't seen or talked to her mother, and instead, was quite unceremoniously shipped off to her grandparents' house.
Her mom was in hospice.
The day after Christmas, my patient had finally gone to get checked out by the doctor for some weird flu-like symptoms that she'd been having. She was diagnosed with ALL. She started treatment right away, but as luck would have it, she ended up getting every single complication in the book. Three weeks later, just as she was starting to clear up all those nosocomial infections, the pathology report came back showing the ALL had recurred.
Since then, it's been all downhill from there. UTIs, pneumonias, sepsis, respiratory failure, kidney failure, anemia, TPN, catheter fungal infections from the TPN line placement, so on and so forth. My patient couldn't catch a break.
She's only twenty-two.
Her husband, whom she married at just seventeen, was constantly by her side. One morning, I walked in to preround, only to find him in her hospital bed, cradling her head in his arms, lovingly stroking her head, her long blonde locks long gone from the chemo. I silently backed out of the room, not wanting to disturb them.
He only left her side once, and that was this morning, to go pick up their five-year old daughter from the grandparents. Mommy was back, and she was finally going to get to see her.
I wasn't there when she was first brought into the room. I don't know what they told her to prepare her for this alien creature that looked vaguely like her mom, but didn't smell or really look like her anymore and didn't respond to her stories about pre-school and baking cookies with grandma.
But I was there when we finally took our patient off the vent. The little girl clung to her mother's hand, as though afraid that if she let go, her mom would vanish into thin air. And the husband lay next to her, at his usual spot, one arm around his daughter, and the other stroking my patient's peach fuzz hair, as he whispered I love you's and promises that he and their daughter would be okay together, would take care of each other, would never forget her, and that while they would miss her terribly, she should go if God was calling her home.
With nothing to help her breathe, our patient passed on pretty quickly. The color in her face disappeared, and her face, although peaceful, looked still and unreal. My attending moved in to check vitals for one final time, and then nodding to the husband, declared her dead at 2:38pm.
He nodded back at my attending, tears streaming down his face, and after kissing his wife one more time, released his death grip on her hand.
The little girl, her face buried in her mother's chest, seemed to know exactly when that happened. And she started sobbing, her pain evident in her cries and desperate pleas aloud, willing her mother's spirit to "please come back, please come back." Somehow knowing that the ventilator had been key in helping her mother live, she grabbed the tube, and frantically tried to force it back down her mother's throat, before her father finally gathered her up in a giant bear hug, and crumpling onto the couch, they both cried and gripped on to each other for dear life.
I started tearing up immediately, and I excused myself from the room, feeling as though I was intruding on a deeply private moment.
I'm on palliative care. I've seen a fair share of deaths. And maybe it's cause she was so young, maybe it's cause her daughter had such a profound reaction to her death, maybe it's because I could see myself in her, but her death was far more painful for me than all the others combined.
Tomorrow's my last day as a medical student. But I know the lifelong lessons are only just beginning.
4 years ago
