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On My Mind
February 2017

Goodbyes Are Not Forever

Author Affiliations
  • 1Pediatric Critical Care Medicine, The University of Alabama at Birmingham, Birmingham
JAMA Pediatr. 2017;171(2):109. doi:10.1001/jamapediatrics.2016.2382

I walked out of my patient’s room, composed myself, and continued with attending to the other critically ill children in the Pediatric Intensive Care Unit. As I led a full cardiac arrest code, my calm demeanor belied the wave of emotions that I had suppressed. Several hours beforehand, I had completed a brain death examination on a 5-month-old infant who had suffered a severe anoxic brain injury. I spent the first part of the early morning sitting with my patient’s parents, delivering the news that despite all our efforts, their son had died. As an intensivist, this was neither the first nor the last conversation of this nature that I would have with families. In truth, I would have many more of these conversations—different children, different mechanisms, but ultimately the same fatal prognosis. I counseled, comforted, and mostly just sat with the families quietly, in the end. I knew how to have these conversations, and how to simply be there during these silent sittings, and yet when death came into my life and took my mom, the experience was raw and foreign.

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