Pole

Bilal Jawed is a IU School of Medicine medical student  and 2019 Slemenda Scholar. He returned to Eldoret earlier this year as a trainee under the supervision of AMPATH clinical faculty and shares one of his experiences.

Warning: child loss

There was a pretty sick child admitted overnight, end-stage disease and looking septic, so I run their test to the lab myself with the blood still in the syringe. The people in the lab seem to understand the urgency without me having to express myself too much. By the time I get back, the child's heart rate is already in the 50s, 40s, then 30s and then we start chest compressions. The other families in the room seem to sense the urgency as well as they clear space on the bedside cart for me to put my things away to get ready for what's coming.  A cup of uji splashes in the hurry.

I notice in the scramble that the epinephrine was not called for so I make sure the nurse hears my voice when I ask for it. My voice sounds strange, like someone else’s more than mine because it’s almost never this loud. I start compressions now. When you're actually doing the compressions it's easy to zone out and forget that you're not in one of your many basic lifesaving courses. But then you feel the ribs and remember this is a human and the compressions become magically harder somehow. Second-guessing starts. A quick adjustment of your shoulders and locking of the arms that you forgot about on your second or third set of compressions. You worry that you're going too deep or not deep enough even though you've done hundreds of beats and your team is saying your compressions are good. I start to feel sweat on my back. I call out times. It goes from 5 minutes since compressions, to 10 minutes since compressions. I start to feel desperate. 15 minutes since compressions. 20 minutes. We call it at 21 minutes. The death exam has no surprises. The entire room looks stunned. Those poor children in the room who just had to watch. I wish I had the state of mind to have them clear the room.

Adobe stock photo

The dad wearing his crisp suit folds to the fetal position. You can’t see his face, you just hear him crying. He then puts his head on the child's chest, presumably to check for a heartbeat. This is the moment my cup overflows. I feel glad my facemask is able to absorb my own tears because my hands aren’t clean to wipe them away. The dad wails in various positions. I say pole [sorry] but there's no way it reached him. I didn't really think it would. It's not about me. It's not about me getting to console him so I can feel better about the silver linings of my day; that I was able to at least alleviate his suffering today.

Later that day I see the dad, still in his crisp suit. I wonder what circumstances in life lead him to wear this suit and today of all days. Or does he wear a suit every day? He has this sort of very blank face that is not necessarily sad, a “just there” face. He is asking one of the nurses the logistics for "clearing the bill" for the body at the mortuary. An unfathomable act. I am working through some patient charts at the stand-up desk where he walks over to in order to look at his own papers. I so desperately want him to turn to me and say something like “thank you for trying” or “you did your best” so I can selfishly feel better that I wasn’t able to save his child. He says none of these things. He is just a father who lost his child today. I pat his back and just say pole again. He nods a type of nod that I can't quite translate. My last image of the dad is him walking out of the wards, looking almost the same as when he entered, but now, entering what I can only imagine is, a whole new world for him. I go back to seeing patients.