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Perhaps those of you who work in medicine, or the helping professions can relate to this.

When you work in an ER you get to see some strange things, some horrible things, and sometimes, some truly unspeakable things.

Once in a blue moon, you get to experience something amazing.

It might be the only thing that keeps us sane.

As a physician in the ED, you haven't really 'seen the elephant' until a mother crashes through your back door with a limp, blue child in her arms, screams "My baby isn't breathing!" and flings it into your arms.

Suddenly, it's hard to breathe.
Your heart jumps into your throat.
It's like the worst stage fright you can imagine...and this is the biggest stage there is. Only it's not some TV show, or the school play or your first recital in grade school.
This is the real thing, and some innocent child's life is, literally, lying in your hands.

The first time it happened to me, I was a second year resident, a naive rookie, moonlighting in a small country ER.
Far too many times since then, in the course of my career, I have done everything in my power, even far beyond the time when everyone in the code team knew it was hopeless, because, dammit, it's a kid.

Codes on children are different.
In adult codes, sometimes there is grim, gallows humor. There is jocularity, the kind medical people use to screen out the pain of watching yet another death, in a long line of them we see every day.
In children's codes there is no humor.
There is no gallows joking or dark comedy.
Faces are grim and humorless and sometimes streaked with tears.
Most of the people, the physicians, the nurses, the RT's, and radiology techs, the ER techs...most of us in the room are parents.  
No one wants to call a code, officially ending the life of a child.
But at some point, you have to.

Then you have to make the long, long walk to the "family room"...which is a euphemism for the room that all ER's have. It's where you put families where you can tell them in privacy that their loved one has died.

To tell parents, who are clutching one another like they are hanging onto whatever they can grab to keep from being swept away in a flood.
When that door opens, their faces automatically snap toward you, and the looks of hope and despair mingled together are among the most horrible things you will ever see. Their faces tell you...beg you...not to say what they already know you are going to say.

Drownings, accidental shootings, accidental poisonings, car wrecks, falls, you name it, we've seen them all, and had to make that long, long walk to 'That Room'.    

Once in a while, though, we win.

The nurses throw down the Broselow tape, and the respiratory therapists grab the suction and the oxygen, and by God, we Rock And Roll.
We fight the Grim Reaper tooth and nail, because, dammit, it's a kid.
It could have been our kid.
It's sure as hell SOMEone's kid.
We suction them, and bag them and grab for the glidescope and the ET tubes, while the RN's slam in IV lines and crack open the code cart, and then....you hear it...
A breath.
A gurgle.
Then crying, and maybe a scream.

Relief explodes into the trauma room like a tear gas grenade.  
All of a sudden, it's like Christmas, New Year's, your birthday, anniversary and Mardi Gras, all rolled into one.
Faces light up, and suddenly everyone is smiling, laughing and joking.
Sometimes happy tears roll down faces...and not always just the nurses either.
The walk to That Room becomes a stroll.

We won tonight.

In the end, of course, death will claim us all.
Our carbon, nitrogen, oxygen and hydrogen atoms will return to the cycles and we will become one with the wind, the water, and the dust.

But tonight?  

Tonight, We listen to the music of a child crying, echoing down the late-night empty halls of our ER, and it's better than any symphony ever written...

Originally posted to Aviator Doc on Tue Aug 12, 2014 at 02:00 AM PDT.

Also republished by KosLit, Three Star Kossacks, and KosAbility.

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