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The Night Your Child Died: An Open Letter From Your Doctor

Bernstein, Sarah Mongiello MD, MHA

doi: 10.1097/ACM.0000000000001365
Teaching and Learning Moments
AM Rounds Blog Post

S.M. Bernstein is a second-year resident, Department of Pediatrics, University of Illinois at Chicago College of Medicine, Chicago, Illinois; e-mail: sbernst1@uic.edu.

Author’s Note: The name in this essay has been changed to protect the identity of those described.

An AM Rounds blog post on this article is available at academicmedicineblog.org.

I was there the night they cut you open. I got the call for the emergency C-section and quickly raced to the OR, tearing off my jacket as I ran. I hurriedly scrubbed in and watched the obstetricians expertly slice through your abdominal muscles, down to your uterus, where your tiny baby was waiting, fighting for his life. The heart monitor behind me ticked slower and slower, indicating trouble.

They pulled his limp body from your open womb and placed him in my ready hands. At just 24 weeks, he weighed barely more than a pound. I grabbed my stethoscope and listened for his beating heart, but all I heard was deafening silence. We intubated him immediately, and I held my breath as I watched his little chest rise with each pump of the bag. Just as I readied to start chest compressions, the tick, tick, tick of the monitor returned and I exhaled. Quickly, we transported him to the NICU.

I was still putting in orders when your husband walked in, eyes red and swollen from crying. His hair was all disheveled, and he looked so lost among the sea of bodies, swarming around him, grappling to keep his tiny family alive. I brought him a chair so he could sit down. Even amid the chaos, he looked me in the eyes, gently squeezed my hand, and said, “Thank you.”

I’d read from your chart that you’d used IVF to conceive, but I didn’t need a chart to tell me how much you both wanted this baby. For weeks, I cared for your son nearly every night. I ran to his side every time his oxygen levels dipped. I monitored his urine output obsessively. I thought about every aspect of the nutrition we gave him and the antibiotics we chose to treat him.

The night he died I was on my intern retreat. It was supposed to be a weekend away from the stress of residency. I had just set down my bags when someone asked, “Did you hear that Baby M died?”

“His name is Aiden,” I replied, coldly.

I was angry that I hadn’t been there to perform chest compressions on him. I was angry that I wasn’t able to hug you. I was angry that I couldn’t save him. Mostly, I was just angry. Every day I see children who are beaten and abandoned by their parents. Then I see you and your husband. You desperately wanted this child and he died. There are some things in this life that will never make sense to me.

Weeks later, I sat with my sister, who was seven months pregnant at the time. She mentioned that in some cultures it’s bad luck to decorate a baby’s room before he is born. Immediately I thought of you. I thought of a room painted the perfect shade of blue. I thought of walls lined with baseball bats and the blanket his grandmother made. I thought of perfectly coordinated outfits that would never be worn and a crib that would never be slept in, and my heart broke for your loss.

Maybe it was selfish for me to grieve a loss that was so clearly yours, but I want you to know that your doctors do grieve. We grieve for the life that could have been, for your shattered dreams and dashed hopes, for the person he could have been. We grieve for your grief.

Somehow through that grief, I learned to celebrate new life. Aiden taught me something medical school never could. He taught me how to love my patients and then he taught me how to let them go. He taught me that the lessons of medicine don’t end with death, and he reminds me every day to be more empathetic, more compassionate, and more forgiving, because sometimes all we have in this life is just a few precious breaths and then we’re gone.

Sarah Mongiello Bernstein, MD, MHA

© 2016 by the Association of American Medical Colleges