We Have Limitation
The paediatric posting just ended few days ago. On the last day of my duty in NICU, I realized how fast the time travels day by day. It was really hard to say goodbye to all the senior doctors and staffs who had been working together for the whole month. They taught me a lot during my day in the department.
The saddest part, is to declare the death of the babies that we cared for. I had been through that kind of feeling, when, after careful monitoring of the baby everyday, they had no chances to survive.
One of the babies that I had to monitor also got the same fate. He was a premature baby of 26 weeks of gestation. Normal pregnancy should be at least of 36 weeks. See how many weeks that had been lagged behind. The baby presented with micropenis (small penis), low birth weight (approx. 1kg) and also edema (swelling of the face and body). He was on ventilatory support to assist him in breathing. He had to be monitored closely. For every hour, the water collected from the tubes of the ventilator had to be emptied. Suction of the oral, nasal, and endotracheal tube should also be done hourly or when needed. The temperature, blood pressure and the heart rate should also be monitored and charted hourly.
On my first day in NICU, the baby had been there for about 3-4 days. One of the senior doctors said to me that the child is dying. Then, I asked him back, “Are you sure?” Others started to laugh and smile with my query.
Although he had very less chance to survive, I thought this was God’s plan to have me there and serve this little poor baby before his time’s up. And I couldn’t care less about what others were saying about no hope at all. I knew that they also wanted the best for the baby. That’s why I kept doing the routine work so that in the future I know how to manage patient of the same situation.
The biochemistry report of the premature baby was not that bad. The blood sugar, sodium, potassium, urea and creatinine were all within normal range. This indicate that the kidney function very well.
But, what is fated could not be changed. On the same day, the last day of my posting in paeds department, I heard that the parents of the baby were going to take DAMA (Discharged Against Medical Advice). They were going to bring back the baby home in the evening. I thought that my job was done. When I left, the baby also left the NICU. Nothing was reserved for him here in the hospital.
Then I went back to my room for tea break. When I returned to NICU, the same baby died already. Ventilatory support had been removed from him. The nurse told me that he died 1 hour before. I felt pity for the baby himself. I thought, he was having premature development of the lung due to prematurity. That’s why, instead of giving the respiratory aid, why don’t we let him go. It was much more appropriate thing to do. Doctors also have limit. They are not God. They have no power regarding life and death.
Before I left, I saw the baby for one last time. This was the child that I monitored for the last 7 days. And now, he had gone to a safer place. Maybe this world is not good enough for him to stay. Coincidentally, I finished my posting on the same day. When I left, he also ‘left’. Only God knows what is the message behind this storyline of life.
Doctors can only try and do something. Sometimes, they failed as they are also human being.
What matters more, the lessons to be learnt in order to improve ourselves for a better future.