The Boy With the Broken Heart
- 24 Antonio was admitted to the Pediatric unit one night with breathing problems. We don't have a Pedi ICU, but he was assigned to an experienced nurse and hooked up to various monitors. The ER doctor had diagnosed respiratory distress, but as time went by the primary nurse became more anxious. She tried to hide her anxiety from the parents, immigrants from Mexico who spoke little or no English. Mom wanted to lie in the bed with the four year old, but that made it too difficult to manage his care, so she had to sit beside the bed. She kept her face close to his, whispering softly to Antonio. Dad stood behind her with his hands on Moms shoulders. The three were physically connected. The primary nurse and I, the Charge Nurse, called the Pediatrician on call multiple times about our growing concern for Antonio's distress. Breathing treatments were not working. Blood gases were marginal. The doctor talked to us, gave us more orders, but saw no need to come visit Antonio despite our pleas. We wanted Antonio transferred to a Dallas hospital, but the doctor thought we were over-reacting. Finally, I phoned the House Supervisor (for the third time!) and insisted that he initiate chain of command. The House Sup, the ER doctor, a Pharmacist, a Respiratory Therapist all showed up to brainstorm. The Pediatrician arrived, a little put out for the inconvenience. By that time Antonio's heart rate had dropped to 60 bpm and the primary nurse called a code. Antonio died that night with his parents in the room, crying as we worked.
Our state requires that an autopsy be ordered for any death within 24 hours of admission, unless over-ridden by the physician. The physican was in a state of shock. He just could not believe the child had been that sick. A nurse had to set him down, and let him recover. Meanwhile, I had the parents to console. Although I am well-traveled and have been exposed to many cultures, I only speak English. I arranged for a medical interpreter via the phone line. The parents could barely speak, but it was clear they were outraged over the need for an autopsy. The physician wanted one because of the circumstances. Why had Antonio died? The parents just wanted to take Antonio home and have a wake in their house, surrounded by friends and family and their own priest. But no. Antonio was not to go home again.
We allowed the parents to grieve for a while. After they left I went with the House Sup to take Antonio to the morgue. I truly understood death when I saw him placed in a cold vault.
Later we learned that Antonio had congenital cardiomyopathy, which had never been diagnosed or treated. His heart just gave out after four years of struggling. I think about his parents and how they were not permitted to take home their boy. They were in a strange country with strange customs and a strange language. Who comforted them?
I now believe that as we are exposed to other cultures we become more flexible in our way of thinking, and learn to accept some differences. However, when it gets down to birth and death, each of us has our own culture about the "right way" things should be done. Antonio died of a broken heart, but his heart touched all of us that night.
classicdame has '>20' year(s) of experience. From 'Texas'; Joined Jun '06; Posts: 7,145; Likes: 6,680.