whoa, what just happened?

I experienced my first cardiac arrest today... in the neonatal intensive care unit (NICU).

I experienced my first death in the hospital... the death of a tiny little baby.

Without saying too much, this newborn baby has been pretty sick and no one could figure out why. They (the consultants and registrars) had spent a while discussing this baby at the morning handover meeting, but I didn't think too much about it myself. Then, having been assigned to NICU for the week, I met this baby and the whole family an hour later on our ward round -- and indeed the baby was unwell but stable. It was pretty hard going for the family who knew things were getting serious and, in some ways to an outside looking in, it kind of felt like they were preparing themselves to say goodbye, like as if somehow they knew in their heart of hearts what was to come.

It was later that afternoon that all of a sudden there was an explosion of beeping from one of the NICU monitors, followed by hushed exclamations of "Where's the doctor??!?" Before I knew what was happening there were two registrars, one house surgeon, two nurses (with the consultant on the way)... and me, standing, just standing there, watching it all unfold in front of me like a scene from a TV show, but this time in slow motion and with hushed voices in an otherwise silent and frozen NICU. And in those next ten minutes it was like everyone else in the room was holding their breath, completely paralyzed, afraid that one wrong movement might somehow change the fate of this little baby, dusky blue, teetering on the edge of the precipice that is life... or death.

I was frozen. I just stood there. They didn't need me, and, frankly, I had nothing to offer. No skills, no understanding, no knowledge. My role, I quickly realised, was just to take it in.

You know in First Aid course when you practice CPR on those mannequins? And on "Annie" (the adult mannequin) you're supposed to use the force of your entire upper body to perform the compressions? (To quote one of the instructors, "You're not doing it right if you haven't fractured any ribs.") But then afterwards they bring out the infant mannequin and teach you to use two fingers? Two fingers. Two fingers of one hand for compressions. I always felt a little ridiculous doing that, like, honestly, would two fingers really be enough??

After my car rolled off the bank in Motueka the image that stayed with me (and remains with me still) is the blurred view of the green and brown forestry through the windshield as my car tumbled on it's side, like being inside a glass hamster wheel looking out. In the same way, the image that haunts me from this afternoon is of the registrar's two fingers pushing up and down on this tiny little baby's heart... and on this tiny, fragile, precious baby, two fingers really were more than enough.

After about fifteen minutes of resus, as the registrars continued to do compressions and bag ventilate, the consultant went over to the family to explain to them that they would now stop doing compressions and that it was time to say goodbye. And it was then, as they started to extubate the baby, that it was too much for me. I stepped outside, left NICU, and in an empty hallway at the back of the fifth floor, started to cry.

It sucks. Plain and simple. And it breaks your heart. I can't even begin to imagine what it's like for the family. I only met the little baby this morning and it was enough to break my heart; I can't even begin to fathom what it would be like had I spent every single moment of six, seven, eight months with a baby that was inside of me, then to watch it die before it even had a chance to live.

Needless to say, it was a pretty intense first day. And to be honest, I think I'm a little shell-shocked.