A Piece of My Mind Section Editor: Roxanne
K. Young, Associate Editor.
Just before dawn we received a call that an unresponsive infant was
being brought by emergency medical services to our hospital. As the medical
team—the pediatric resident, intern, respiratory therapist, nurse, and
me—prepared for the incoming patient, an eerie silence enveloped the
trauma room, an event that frequently precedes a pediatric resuscitation.
The child arrived in our emergency department pulseless and cold, with
compressions being performed on him in the arms of the paramedic. Further
history obtained by the paramedics indicated that the mother had left the
infant alone in the home with two young children to watch the child, and upon
her return the infant was found in bed not breathing and cold. As a medical
team we simultaneously performed multiple procedures (intubation, insertion
of intraosseous lines, administration of epinephrine, cardiac compressions),
all to no avail. Twenty minutes after he arrived, I declared this 2-month-old
child dead with a high suspicion of abuse or neglect. Everyone vacated the
room almost immediately, except for the nurse, who never left the child's
bedside. I asked her why she needed to stay, and she looked at me and smiled.
"Why of course, to be with my patient a little bit longer."
Spiro D. A Little Bit Longer. JAMA. 2003;290(6):716. doi:10.1001/jama.290.6.716