Day 18

Running behind on posts because I had a busy day which is always good because busy days go by faster and bring Mike here sooner.
I went to the Childrens hospital again today and it was fascinating as usual in actually a very sad way. In the morning we coded a baby and recovered the heartbeat (all run by the fellow, the attending didn't even leave his office). Then after, I noticed that the monitors had flatlined and thought it was just the monitor because if the baby is coding again then we should be resuscitating him, right? Then after awhile the nurse wrapped a sheet around the baby and it was obvious that this wasn't a disfunction of the monitors. I was confused. I know I miss details in Spanish, but I was there for the code and didn't understand why after recovering the heartbeat and re-attaching the ventilator they would just let the baby die. Fabiola (a second year resident who I adore and want to bring home with me) explained to me that the baby had needed a medicine and so had the girl in the bed next to the baby. The matter was life or death for the baby and not the girl and so the baby was supposed to get it because there was only enough for one patient (the hospital was otherwise out until further notice and couldn't quickly get more from a nearby hospital). One of the nurses, doing her job and not realizing that the medicine was in short supply gave the medicine to the girl and therefore there was none for the baby. I had watched the interaction about the medicine between the pharmacist and the PICU fellow/residents earlier and had understood that a medicine for one patient had been given to another patient and that there wasn't any more, but I had not grasped, based on their conversation, the gravity of the situation for the baby. Its not that there is never a time in the US when we don't have a medicine we want/need, but I have never seen a life or death situation where we can't get the medicine or give something to keep the patient alive until we can get the medicine. The doctors here see it often. Death doesn't seem to bother them like it bothers us because they see so much of it, or maybe they just hide there emotions better. There was no crying family at the bedside because it didn't happen during visiting hours (I assume someone told the family outside where the familys tend to sit all day waiting for visiting hours so they can see their child). The whole PICU didn't take a moment to give eachother hugs of support. Except for a few glances in the direction of the baby as he was wheeled out of the room wrapped in a sheet, morning rounds went on like nothing had happened.
The priest came through later in the day to say hi and Fabiola explained to me that sometimes he helps them when things are tough so I know they feel it. However, this is the third patient I know if that died this week in the PICU so I guess if you cried and fell apart every time a patient died here like I do in the US (sometimes I make it home, sometimes I cry openly in the halls of the hospital, I can't help it) you would have serious problems completing your residency. We all need to develop different levels of thickness to our skin to make it through. Guess here you just have to get even thicker.