A Piece of My Mind
September 8, 2015

Love at the End of the Beginning of Life

Author Affiliations
  • 1The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, and the Perelman School of Medicine, University of Pennsylvania, Philadelphia

Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2015;314(10):1001-1002. doi:10.1001/jama.2015.5944

At 2 o’clock in the morning, as the situation went from bad to worse, I stepped away from the bedside to call the parents.

Looking back, I knew the prognosis for the 6-month-old girl born with a severe congenital heart defect had never been good. Shortly after birth, her lungs had gotten very sick. Her condition had deteriorated gradually, every day being either no better or perhaps a bit poorer than the day before.

But in the way that incremental bad news can accumulate yet go unacknowledged—that is how we came to 2 o’clock in the morning and the sudden realization that an inevitable crisis had been unfolding slowly for weeks on end.

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