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This blog forms part of the BMA Cymru Wales International Stress Awareness Day Series
Dr Iain Robbé is a former Medical Academic, currently working in clinical medical education with several medical schools in the United Kingdom and Canada.
More than thirty years ago, I was a 27-year-old junior doctor who was first on call for paediatrics in a district general hospital on a Saturday afternoon. A ten-month-old girl was rushed in to the emergency department having collapsed in her cot next to her parents, who were having lunch with friends in a restaurant. Two anaesthetists, several emergency room nurses and I managed to restart her breathing and her heart beat but she was gravely ill.
The next member of the paediatric team was the registrar who was based at the other general hospital six miles away, so my consultant was called to come in from home. Also, arrangements were made to transfer the child to a specialist children’s hospital five miles away.
The emergency room was normally noisy and I remember the eerie silence when the senior nurse asked me to talk to the child’s mother and father. The nurse and I went to a nearby relatives’ room and I sat down with the child’s parents, who were just a few years older than me. To this day, I have the image of the father’s ashen-white face that almost blended with the clinical, white painted walls of the room. He was rubbing his eyes. They were red, as if he had conjunctivitis. I have only the dimmest memory of the mother – black hair in a 1980s bob, but I have no image of the rest of her face.
I tried to put into practice my training in communication skills, particularly empathy, and I answered the parents’ questions as best as I could, finding time for silences. I hope they understood that even though we were transferring their daughter to a specialist hospital, she was gravely ill.
I went with my patient in the ambulance for the transfer to the specialist hospital, where she died a few hours later. The cause of death was given as cot death, which today would probably be given as ‘sudden infant death syndrome.'
I never saw the parents again. My consultant went home as soon as I returned from the transfer. I continued my shift for the rest of the weekend, until Monday afternoon.
I have often wondered how those parents coped after that afternoon. Their happy Saturday lunch had changed in an instant to one of the deepest fears of a parent; their child had become gravely ill, and they were faced with the pain of their infant’s death. There was less support for bereaved parents in those days than there is now.
As for me, there was little training for medical students or junior doctors in building resilience and I am sure I could have benefited from improving my communication skills and my self-care. Regularly in the subsequent years, I have thought with sadness about this child’s death, yet it was a privilege to be involved with her and her parents. I wish I could recall the mother’s face, as it seems disrespectful not to have retained that image.