The first time I partook in a baby’s resuscitation was during my fourth year of medical school. It was a disaster: the wall-suction malfunctioned, the nursing staff were in the precarious business of changing shifts, and all algorithms flew out of the window.
I vowed optimistically that when I was a doctor, I would not let a baby die that way.
I had a lot of criticisms, which is so easy for a student to do; but I did learn from it. I learned to prepare myself mentally for any scenario where a life may need to be saved, so that I could give that life a fighting chance.
Last night it was my turn. I was called to the ward for a desaturating baby with pneumocystis carinii pneumonia (PCP). It was my call to start bag-mask ventilation, and then to start compressions when his heart rate dropped below 60.
I have not done formal APLS, and I had to draw on every bit of information I recall from medical school training. (I’ve only been doing paediatrics for a week now.)
But it was a beautiful resuscitation. Even though the nursing staff were also changing shift (why does it always happen like that?) they were in top-form. Anything I asked for was there. And when I asked for my senior, she arrived too.
The wall-suction worked. The intubation tray was ready. The adrenaline was prepared correctly.
It was our first time doing a resuscitation together, but we worked like a well-oiled machine. No single person could take credit: it was a matter of everything coming together as it should.
Not to say that there is nothing I would do differently, of course. But after mulling over every action for the past 24 hours, I realise we did not miss anything that could have meant the difference between life and death.
And still, the baby died.
My fingers felt it when his tiny heart stopped beating. They probed searchingly, full of hope for it to start again.
It did not.
We resuscitated for more than an hour.
I really did believe that the resuscitation would be successful. In the moments between deciding to start full-blown CPR and actually doing so, I banished my self-doubt and focused only on the child.
And so I learned a new lesson last night: that, even when you do everything “right”, you may still fail.
Babies still die.
And mothers still have to take the harshest news there may be.