Date: Fri, 6 Oct 1995 19:17:35 -0400 (EDT)
From: Marcus Eubanks (email@example.com)
To: Mum & Dad (firstname.lastname@example.org)
Day cleared up roughly 10.30 to reveal glorious warmth & gentle damp. Sun streaming from all points and 82 fucking degrees. Saw consults this morning, and whilst chowing down on a cholesterol calamity the Fellow breezed by and told me I might as well blow & enjoy the afternoon. Didn't make him say it twice. Vehicle of bliss in this case were sleep filled with strange hypnogogic images & noise from my subconscious. Not unfulfilling, but undeniably bizarre.
Prominant background soundtrack was medical doubletalk. Not suprising in the least.
We have three dead kids on service, as of this afternoon. I don't mean the sickness unto death, I mean warm breathing corpses. Or not breathing, not exactly, but their hearts continue to perfuse their tissues as long as we blow air into their chests with our fancy pumps. Brainstem activity nil. EEG flatline, plain & simple.
I'm trying to figure out how to hold the scenario in my mind but having only scant success. True introspection would probably reveal that these three shells aren't properly in my mind at all, but rather walled off in some little ghetto out beyond the edge of conscious thought. Not sure I really want to go exploring that vast uncharted territory though. Suspect there's some pretty dangerous shit floating around out there, land mines, cortex-bombs & the like. Unwittingly trip the wire on one of those ugly existential claymores and I could end up blowing my frontal lobes clean outta my head.
You wash your hands before & after you touch each kid. I prefer chlorhexidine myself, 'cause it's viciously anti-microbial, and if you use it daily you actually build up bacteriostatic levels in your skin. It's the beginning of RSV season, and the respiratory syncicial virus which gives you or me a drippy nose can put a two month old in a pine box.
So hands sterilized, I examine these kids. They're cooperative patients, that's for damned sure. Bright lights, pins & needles, nothing fazes 'em in the slightest. Studies in quiet reserve and aplomb as I stare at the backs of their eyes with that bright light that doctors like to blind you with.
This here is retinal edema. Back of the eye with engorged vessals and diffuse swelling, rendering the whole field opalescent white. This active child just suddenly seized and stopped breathing. Act of God, just nothing at all anyone could have done to prevent it. Thank you, Lord, for your infinite mercy and glory. Family totally dazed. Suspect they'd like to wall this off from conscious thought as easilly as I do, but there's this nagging matter of an empty bed back at home...
That over there is an exquisite example of retinal hemorrhaging. There are little islands of glistening red everywhere. Remember this picture, because it's depressingly common. The literature shows *one* case where it resulted from aggressive CPR, but only one. The other twenty-nine kajillion cases resulted from trauma, usually shaking. -You know, you grab the little shit by the shoulders and shake him back and forth vigorously while you scream, "Shut up, damn you; just shut up!" Astoundingly, it actually works if you do it right; they never make another noise.
This little girl over here was brought to the e/r by mom & dad who tell us she had three days of vomiting and diarrhea. How the puking runs can cause occiptal fractures is beyond me, but you how kids are... Them wacky little buggers just run around like mad, bumping into things all the time. Her EEG took two days to flatten out completely, but this morning it's as placid as a supersaturated arctic lake.
Oif. Visa will be buying me & Scheidler beers tonite. Call the fuckers up won't you, and tell 'em I said thanks? We'll probably bitch about nasty nurses and classmates of the double-x variety, and pine over cute ones. We will undboutedly make mysogynist jokes while we look longingly at the swells & curves all around us. We may delve yet again into the recurring facetious homo-erotic theme about the unlikely combination of me & him and his labrador retriever. We might even make grimly cruel jokes about dead little kids.
We will *definately* revel in the fearsome joy of life.
Copyright © 1996 Marcus Eubanks, M.D. All rights reserved