In All My Career…Stories from the ED


 

 

 

 

 

 

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Dead Mother

More than a decade ago, I was working in a suburban ED when a mother and daughter
were brought in at about 10 a.m. from a motor vehicle accident. The daughter was fine, the mother (immobilized on a back board) at first blush seemed fine to paramedics and triage. Vital signs were initially normal. It was quiet in the department and I immediately walked in to see her. She grabbed my hand, looked me in the eyes with terror, and died, all in the length of time that it took to write these few sentences. This was a young woman in her thirties with a young daughter. This was not acceptable. I had to literally peel her fingers off of my hand so that I could begin the interventions. Technically, everything went smoothly but she was definitively dead from the outset. Having watched her die squeezing my hand, I went the extra mile and opened her chest, cross clamped her aorta, performed open cardiac massage. These were desperate measures that everyone would recognize as futile in a blunt trauma; I had neither the skill of a thoracic surgeon nor the backup for such efforts. But I could not stand by without trying everything possible to undo what fate had dealt. This is not a happy story; the dead remained dead. And I was emotionally wrought from having to deal with such an unexpected outcome which had stretched my abilities to no avail. Now the really difficult part began. I had to talk to the nine-year-old daughter, the same age as my own son. As it turned out, this was her stepmother; the child’s biological mother had previously died in an automobile accident in which she had also been a passenger. Her father had been incapacitated in an industrial accident a few years previously, another patient with which I was very familiar. Her aunt and uncle were with her by then and after a brief conversation with them, we elected that I would deliver the bad news. “NO, I wanted her to see me grow up!” I was stunned not just by the volume of her scream but by the apparent maturity of it. She wanted to visit with her mother’s dead, and now mutilated, body. How can I permit that? Who am I to prevent that? I can hardly describe the grieving that we all did at the cruel blow that fate had dealt this poor child. This day will be etched in my memory for the rest of my life. Life went on and in the ED, patients kept coming; eventually I had to put on my game face and go back to work. Some sick people, but mostly people with routine problems, had filled up the department. None of them were privy to the tragedy that had just transpired a few yards from them; they were concerned with their own legitimate issues. I had to put it all aside rapidly; further grieving would have to be on my own time. Two days later, I was again working the morning shift when the triage nurse summoned me to the front desk. There the very same nine-year-old girl stood waiting to give me flowers. She had stopped by on her way to her stepmother’s funeral to personally deliver them.

Several years ago I came across a human interest article in the local newspaper. There was the same child now graduated from high school, having grown up with her grandparents. All the memories flooded back to me.
Used with permission by EPMB.
Charles Grassie, MD

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