It was an orange summer evening; a warm breeze was blowing outside. I was inside, working, and the little girl I was called to see was barely clinging to life.
Her head was swollen, her body bruised all over. Her pupils were so big that her irises were the barest ring of brown around the empty black. I swallowed hard as I reviewed the CT scan. Her brain was a uniform grey, interrupted only by flecks of bright white in the depths of the brainstem. Duret haemorrhages.
Only hours earlier, the family of five were traveling out of town on a holiday. An oncoming vehicle swerved onto the wrong side of the road. Four members of the family sustained minor cuts and bruises. Cruelly, the brunt of the impact was borne by the 6-year-old girl.
There was nothing we could do.
The distraught mother had refused to leave the girl’s bedside. She already knew. “Always listen to the mother” I was taught in my paediatric rotations. The father and the two siblings came into the meeting room with us. It was time to tell the family. Their eyes showed no sign of the fear I was certain they must be feeling at that moment. I breathed a sigh of relief mixed with shame when the ED physician volunteered to do the talking.
Over a decade later and I remember most how they faced the fact of their daughter’s imminent death with a calm dignity. Their gentle acceptance humbled me then. It humbles me still.
My colleagues got up to leave. I had somehow held back the tears for over an hour now. A few glanced as I lurched towards the sink. I was not sure if I was going to vomit or cry.
I was alone, my vision blurred by tears. I’m not sure how much time passed, but eventually I washed and dried my face and left the room.
Back to work. There were more patients to be seen.