I’m pleased to welcome back Dr. David Carnahan as he writes about a personal experience caring for an Iraqi youngster during his military service.
Welcome back, David.
It was easy to hate the people who had produced the martyrs of 9/11. Maybe hate was too strong a word, but I certainly had no compassion for them, even though I’d taken an oath to do so. That was until one night in Iraq, when the squawk box relayed a trauma on its way in.
The squawk box sounded again in staccato sentences. “Vitals stable. Patient fell off roof. Fall distance: twenty feet. Seven year old boy trying to fly his kite. Significant head injuries. Would call the Neurosurgeon. Over.”
Trauma Tahoe arrived listless and unresponsive with a bluish hue. Orders reverberated off the walls as the Trauma Czar, Dr. Garrett, directed Tahoe’s initial resuscitation, stabilizing him for his eventual surgical care. Within an hour, he was taken to surgery and then placed in the Intensive Care Unit on the ventilator.
The next morning I got up early to check on him. His physical examination had degenerated, and now showed signs of herniation, a condition incompatible with life. The ominous signs on the initial CT scan suggested that Tahoe had suffered severe damage akin to having major strokes on both sides of the brain, and had little chance of recovery, but we all were praying he would be the outlier. The neurosurgeon leaned against the door of the “doc box,” the room where the doctors stay overnight to care for the ICU patients. “There’s nothing more we can do,” he said. All gazes cast downward, and the room remained quiet. We had all arrived at the same conclusion, but saying it had cast the reality into the universe with finality.
The pediatrician, ICU director, neurosurgeon and I walked into the room, and looked at the silent, unconscious patient. His head was wrapped in white bandages. His long, dark eyelashes curled up hinting of his former handsome features, but his swollen face now cast a shadow over his angelic appearance. The ICU staff worked all around me as I watched them perform as professionals: removing tubes, shutting down machines, gradually causing the room to grow still. Dr. Williams, the pediatrician, asked the nurse to bring in the nicest blanket we had. She returned with a hand-quilted blanket sent from a family in Wisconsin.
The beautiful design contrasted against the hideousness of the moment. Then, we waited. The little boy’s father approached the door, his face somber and eyes heavy. The mother was close behind. She was dressed in a black robed dress, shawl and shoes. She held a handkerchief to her face as the tears streamed down her face. Her voice filled the room with an Arabic phrase uttered repetitiously and mournfully. I imagined what I would say, how I would react, and my mind began to whirl as I pictured my own seven-year old daughter in the bed. The father pulled the blanket off and leaned over the bed to kiss his boy’s feet. His tears washed his son’s toes as he slumped over his feet, rocking back and forth in grief.
His mother kissed his lips, brooded over him as she continued to chant the doleful phrase trying to bring her boy back to her. Then as if she suddenly realized we were in the room, she looked up at Dr. Williams and with begging eyes asked him the question in Arabic. The translator in the room knew that he need not explain, Dr. Williams had been asked the question that all doctors despise, the question that raises the issue of the limitations of medicine and the injustice of harm that befalls innocent children. He shook his head and said, “I’m sorry, there’s nothing we can do.”
In that moment, I stood with tear-brimmed eyes, struggling with the sorrow and grief that losing a child will bring.
Dr. David Carnahan is a Board Certified Internist, who fell in love with writing while getting his Masters Degree in Epidemiology at the University of Pennsylvania. He has served in the Air Force for the past 14 years as an academic clinician/educator and now works in the area of Healthcare Informatics. He has a wonderful wife and two beautiful daughters, and invites you to read about his life (www.dhcarnahan.blogspot.com), and weekly installments of his current work in progress, The Perfect Flaw (www.theperfectflaw.com).