Unfair

I'm on pediatric neurosurgery right now. It's my second and last week which is now quickly coming to an end (such is clerkship - time absolutely flies!). I've been missing vascular and the team very much but this has been another eye-opening learning experience.

Peds neurosurgery. How do I describe it. Fascinating. And tragic. Very tragic. Seeing kids sick is not fun. That's not to say there aren't miracles and kids don't get better. They do! And when this happens it's a truly wonderful thing. But when they're sick, and I mean some of these kids are very, very sick, it's so hard to watch. It's hard to separate yourself from the situation and so very hard to not just sit and cry.

Last week on my second day on service, one of my consultants invited me to attend an emergency operation that night for a child with a brain tumour. It was some sort of rare metastatic brain tumour which was very large. But she got it out. And when we went to see him the next day, he was doing really well. He was still a very sick little boy but he was doing better, watching his cartoons and asking for Oreo cookies. The plan was to discharge him home and then continue with chemotherapy.

But then things took a turn for the worse. A recent MRI was pulled up. The tumour my consultant took out was gone, but now a second tumour had grown at an alarming rate. It had almost doubled in size since the last week. And what was worse was the appearance of a new third lesion. We had to tell the family.

As we approached them the mom already had tears in her eyes. She knew things weren't right. I guess parents just have that sixth sense. Going into the private room, I asked my resident if I should be in there too for this meeting. It felt so awkward, so wrong, so uneasy. I didn't think I belonged and that I was intruding on such a tragic and private moment. Once in there, the doctor started to speak... about the options, goals, expectations. It was a lot to take in. The mother started to cry again. They said that they had always known this was a possibility. That they knew the tumour was an aggressive one. They wanted to give their child a fighting chance. But at the same time at what cost. They wouldn't put their son through something that was futile. How much more could one little boy take. Was it worth it? They wanted answers. We could not say anything for certain. All they wanted was for their son to be okay. We couldn't even tell that. It was so hard to watch. So hard to be there. I wanted to cry. Wanted to comfort them, tell them it would be okay. That there son would get better. But it was not my place. I did not know them. They did not know me. So I prayed inside for them, for him, for all of us. And I hoped that it would be enough.

They decided to operate that night. There would be no Oreos for our little patient that day. So I had to fight back more tears as I heard him cry because all he wanted was that one cookie.

Peds has been tough in this sense. It seems so unfair. Life seems so unfair for our little patients. We shouldn't have to see little boys on our operating table waiting to have their brain tumour removed. Little girls shouldn't face an unknown future because they were 'accidently' dropped or shaken. We shouldn't have to fix them. They shouldn't be broken in the first place. It's too tragic, all too tragic.

I truly, truly admire all those who work with children. But for me, it's been a tough two weeks indeed.