Eulogy

I've written and re-written this post multiple times, attempting to "get it right." It is written in honor of a family I met at 9pm on my last call night for neurology, coincidentally the same day I wrote the previous post on brain death.

The technical details aren't important. We were called to consult on a case of an 8 year old girl with Rett Syndrome (a severe disorder of developmental delay) who presented with cardiac arrest. Like the woman of the previous post, her heart was beating spontaneously after resuscitation, but she showed no brain stem activity. Most likely, she will have withdrawal of care today.

What struck me most about this was the feeling I got deep down in my gut, that stereotyped heart wrenching upon seeing the parents who had struggled eight years to keep their very sick daughter alive and comfortable, now confronting her brain death without a significant chance of recovery. What must it be like to experience the most horrible thing imaginable: a parent seeing their child die prematurely? How does one find reconciliation in this world, how does one deal with guilt or blame or if-onlys? How does one say good bye? There was nothing good about this situation: the balled up tissues, the welling of tears, the cold sweats, the helplessness.

Tragedy has many faces and she shows herself at the most unpredictable of times without remorse, without apology. No matter how hard we try to navigate our crafts, no matter our courage or experience or ideals, we cannot control how mercilessly we're tossed in this sea churned by fate. I cannot really describe how I feel. I'm not sure I know how I feel. But part of medicine is tiding people through the worst of times, seeing how people cope and respond to the extremes of circumstance, and learning how best to conduct such etudes. Watching someone die is hard but within my scope of ability. Watching a parent watch her child die, that's infinitesimally harder and something that demands explanation or apology but finds any response wanting.