Thursday, July 30, 2009

Code Blue Nursery

I participated in my first neonatal cardiac arrest resuscitation today. I am not ready to write that much about it as I am still processing...but it has been a day where I oscillate between the medical aspect of the event and how much I thrived on being a part of it...and the emotional part of my brain that bobs to the surface bringing with it a wave of overwhelming sadness.

When I got home from work I realised that I had pulled into the driveway, opened my car door and had been sitting there with one leg out of the door and the rest of me in the car for several minutes, totally lost in thought.

Decided that a long tortuous session of power yoga would clear my head, but instead it just made me feel claustrophobic, I needed air.

So I cranked up some Philip Glass and walked to the harbor, watched the sun go down and then walked home. And somehow I still am trying to grasp the dichotomy between how detached I felt during the code and how distressing it became later once I got home from work.

The brain works in mysterious ways. More on all of this later.


Rogue Medic said...

Some calls haunt.

It's when they don't bother you that you need to worry about taking a break.

Dissociating during patient care is a good thing. It allows you to focus on providing the best care you can. Having the emotions catch up with you after the call is to be expected. You were delaying them, not preventing them.

If you let your emotions interfere with your patient care, you will just have more bad outcomes to feel bad about.

There are certain rules about a war and rule number one is young men die. And rule number two is doctors can't change rule number one. -Henry Blake (MASH)

It isn't just applicable to war.

Albinoni's Adagio in G Minor is good for this, too.

Fordo said...

That means you'll probably be a good MD. You're able to put personal feelings aside when you have to, but you still feel those human, caring feelings when the crisis is over.

medicblog999 said...

We all deal with the job at the time, but its after when we no longer have a role to play, that the thoughts and questions come up.

Ive wrote about it in the past with one job that got to me. If you havent read it before, you can find it here:

Keet said...

Hey babe... I used to watch Michelle come home from a bad day at the Cross and sit watching star trek reruns for hours not speaking. I'm so lucky to have had few of those days in my career. The ones I have had, i still have a hard time talking about, and the only way i've made it through them was by running or biking until my head cleared... the important thing is that you are able to do what needs to be done. Sending my best.

Albinoblackbear said...

RM--I suppose late is better than never in terms of having the emotions catch up to you.
Albinoni's is a good one, I agree. It still feels strange to feel that dissociation while it is happening.

Fordo--I hope your prediction comes true. It sounds so much less maladaptive when you put it that way! :)

MedicB--I read your post and remembered a suicide (from antifreeze ingestion) we dealt with in my old ED. He was found by his 13 year old son. I went through many similar conflicting emotions around the event--though I never had to deal with the son. I am sure it would have made it all that much more intense.

KK--Yeah, I remember when she lost that young breast CA patient...thanks for the call to check in!

**For the record--I am not a blubbering mess over this (if that is how this post came across). I just wanted to put down a few thoughts while it was still fresh.**

Bostonian in NY said...

Any code is tough to deal with. Trying to intervene on behalf of a neonate who's life had just begun just makes it that much worse.

Work is work. You put on your grown-up pants, walk through the ambulance bay doors and let your training do its thing for 12 hours...that's what makes you a professional caregiver. You work in the trenches with the best and worst that humanity has to offer...and you become numb to it. The brain has an amazing way of shutting out traumatic events to protect you and to allow you to keep on doing what must be done.

But you can't expect the gravity of something like a child dying in your hands to go away on the car ride home...or ever. It just goes into the background until you pull it back up or it comes back on its own later on. When this sort of thing gets out of control, it turns into PTSD.

Albinoblackbear said...

BINY--it does go into the background. I am always amazed at what comes back to haunt though...that it still unpredictable to me.

**Update** I worked with the doc who ran the code today and he informed me that they were unsuccessfully trying to wean the babe off the vent...babe was still alive...still unsure of what caused the initial arrest...

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