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Some accident, some decision, some omission. Some absolute calamity of circumstance.
If doesn’t matter now. No matter.
There was brain tissue coming out of your ear. I didn’t even know the word for that, I do now: endaural herniation. I touched it with my hand as we rolled you.
Have you ever had so many doctors and nurses around you? We held you within the constraints of our resuscitation. Screwed needles inside the marrow of your bones and cut down your skin to find a vein. We filled you up with other people’s blood.
Fill her up!
We ferried you to the scanner, flanked on every side.
Then returned to read the radiology report: catastrophic. Catastrophe.
We struggled on with you, until it was declared enough, enough now. Fin.
But it was not yet an end, and eventually it was just you and I behind those curtains. I wiped the blood from your face. Scrubbed a little harder at the blood that had become dried within the hair of your eyebrow and took off with it the makeup you had used to make them arch so perfectly.
I wished I had an eyebrow pencil then, so I could return to you some of the face you had chosen to present to the world. I had nothing.
Four members of your family come and I stay, and stand to supervise what is your death. And you will not stop bleeding. It drips. Mop it. Press. Pack it. I do what I can, with the FY1 who has appeared silently to help me. He takes the wads of red, sodden gauze from my hands, beneath the trolley and replaces them with clean ones. I wonder if it is too early in his career for him to have to see such trauma. But it is not and I am grateful he has joined me. We crouch to mop the floor, and your blood is dripping on your brother’s feet. I have no words to tell your family I am sorry for that. An expression and the act of mopping, only.
Drip, drip. Quiet rivers from your ears, your nose your mouth. Ripples of crimson from your scalp. It matts your blonde hair and I can feel the shelf of your skull where it has come in two.
I close my eyes for just a moment and think ‘enough now’ - this is enough. People say that teenagers are stubborn. And when I open my eyes your family are still there staring motionlessly and you have produced another quiet stream of blood. Mop.
Enough now. But these moments are yours and you continue.
I think about the person who might have guided you into this world; pink, wrinkled, bawling and said ‘congratulations, you have a baby girl’. I think of what your parent’s faces must have looked like in that moment.
Your heart stops. I say: ‘She has died now. I am so sorry. Please, take as long as you need.’
This is the final blog which Aoife Abbey will write as our second Secret Doctor. She took the decision to reveal herself in advance of a new book in which she will draw on her experiences as an intensive care registrar. There will be some guest blogs in this slot until a third Secret Doctor is appointed. Read more of the Secret Doctor blog
You’ve made it ok to weep for all that didn’t make it . Humanising them and us
Lovely writing Aoife. Thank you.
I probably qualified before you were born Aoife- and havent worked in a hospital for a long time- but this piece made me weep; and reminded me just how hard it can be for all hospital doctors, and for our students in training. Thank you for reconnecting me
I think of my 35 years of going through this sort of experience. It doesn’t get easier but the patient and the people who love them - they suffer more.
Shocking and moving and humbling. Thank you.
so good of you to write this.
I mean you have done a good thing. For us all who read it.
I am relieved to know that you thought of her as a baby; that, at the moment of her death, you were so aware of her humanity.
I hope the immediacy of it all passes from you, as it did for me, after a few months then years. It's more like watching an old film now.
Thank you for giving us your moments..
What is the capital of Pakistan?