Walked into the peds ICU this morning. My patient is a cute little 12-month-old who had a grand mal seizure with refractory status epilepticus about 8 hours after her year shots. Certain features (such as an abnormally small head) on clinical examination lead us to believe that it was not the shots that made her seize, though they may have contributed. She is doing well and being extubated today.

Next door to her in the bay lies L. Born at 34 weeks and home from the NICU 1 week ago, she's not even supposed to be out of the womb yet - and now probably will never see that milestone. Her parents fed her and put her down to sleep one night, and two hours later she was found limp, lifeless, and pulseless. Resuscitative efforts produced a heartbeat and clonic muscle activity and nothing else. She was transported here to die, really; the chance for survival - let alone meaningful survival - is essentially nil. We wait twenty-four to seventy-two hours, do an apnea test (if the brain doesn't have a drive to breathe, it doesn't have a drive to function) and a brain perfusion test or an EEG. And that's it...
I went into her room when her parents were out, and stood there, just looking at a perfect little baby under a brightly lit warmer and couldn't stop from crying. Morning rounds were subdued this morning, as A presented her case. Nobody asked many questions - we all just listened.
Her grandma wanted to know, he said, if there was something she could do to help someone else.

I don't understand this one, O Best Beloved, and I don't know how to begin to.

now feeling:: sad