19 October 2007

19 OCT Nowhere to hide



19 OCT Nowhere to hide




Good evening. I can think of little today except the young boy who died this morning. He was one of the two boys I have been treating for serious burns. I left the hospital at 1300 this afternoon, but now I'm back at 2200 because I couldn't sleep in my hooch. I'm sorry to share bad news, but that's the only news I got. We all knew he had little chance of surviving the day he came to us. Even his father told me that he had thought he would die when we spoke today after his son's death. He had stumbled into a pile of burning leaves. His clothes ignited and severely burned his skin, turning it to a thick charred leather. For over a week now our staff has worked night and day trying to save him. The nurses put in such long hours at his bedside and it is so emotionally demanding to care for a burned child. I tried to choose the right course of therapy and timing of his operations but in the end I failed him. It just makes me feel empty. All last night he was struggling to get oxygen through his swollen lungs and his immune defenses began to fail. I visited him this morning. He was so ill that I cancelled the surgery I had planned for him. I didn't think he could make it through the day. He couldn't make it through the morning.




I was in surgery when he died. I was washing dead tissue away from an Iraqi soldier's leg stump. His leg had been blown off in an explosion two days ago. His body was peppered with small wounds where fragments of metal had entered his skin. His wounds were clean and he appeared to be healing. After surgery I found the boy's father. I spoke words to him. Interpreter J. translated them. The words didn't change anything. I had watched this man dying a little every day as he watched his boy's body swell, tubes coming out everywhere. When there were little victories, we shared them. One day his lungs worked better. Another his fever broke. Day after day I cleaned his burns and removed dead skin but found little sign that his whole body was improving. Now it is over. The father has gone home to his family with five other children. I think there is no escaping the fact that there will always be a hole where that beautiful little boy used to be.




Last night on backup call I had little to do. I spent the day working on men and women of various ages with wounds on various parts of their body. One boy had open wounds on his legs where the muscles had been to swollen and I was able to close them. Another boy was in the operating room for 13 hours while four different surgeons took their turns to remove his shattered eye, evacuate blood from around his brain, rebuild the fragments of his face with delicate metal bars, and painstakingly reconstruct the jigsaw pieces of his skin. I helped Oral surgeon L. reconstruct the tube in his cheek that made saliva. When the long marathon was over, he still was swollen, but his precious little face was whole again. His mother had been pacing and seeking updates on his condition for many hours. His whole family had been injured together. His father wasn't clear on what had happened. He told us that they had been away from home for several months. When they opened the front door of their house it was as if the entire house exploded into them blowing them backwards. They were seen at a forward base and rapidly flown to us in helocopters.




After finishing my operations, I sat around the hospital. People passed by me this way and that. Many asked me for directions since the surgeons' desk looks so much like an information desk. I worked for a little while on my MBA assignment on the Norwich University website but the connection was slow. People said hello but I didn't have much to offer. I wanted to be alone so I went back to my hooch. I skipped dinner and watched "The Fifth Element". Lelu multipass made me smile. Sleep didn't come. There was no hiding from my thoughts. So now I'm here. It honestly feels a little better to write this down even if it is a one way conversation and I'm dumping on you. Pain shared is halved and joy shared is doubled. I'll look for some joy to share next time. Tomorrow I'm operating on a boy who has had a stoma bag for 5 months after being shot in the belly. He has grown healthy enough to get rid of that colostomy and be made whole. that's a reason for joy, even if the recovery will hurt a little.




I miss you.




Chris

15 comments:

Anonymous said...

Tough day. Sorry to hear he didn't make it.

Keep slogging away...you're one day closer to coming home. San Antonio's going to have a taste of the cool next week...highs in the upper 70's, lows in the lower 50's. Autumn can't be far off.

Anonymous said...

Thank you for trying to save his life.
Walt.
.

rlbates said...

So sorry for all of you involved. I hope sharing did "half" your sorrow.

Jane said...

You wouldn't be human if you didn't feel what you felt. You did your best and more for that boy. Peace be with you, and with his family.

Chris said...

Dear Jane, Walt, rlbates and Anon.,

Thank you so much for commenting. Having some success today and seeing the other burned boy looking great is the stuff that keeps me going. I hope we have a good string of victories before the next defeat.

Be well,

Chris

Holly said...

I hope you read this before you get my letter.
I know you did everythig that you could possibly do for that child. I remember reading the first time you mentioned him. With the extensive burns he had...He probably wouldn't have survived in the best burn unit here in the States. And he definitely wouldn't have survived back in the old days in his own country.

I'm glad thing are going better today. And you can share bad news with us ANYtime atall. You're the one in the warzone, Doc. You share anything you need to share.

Stay safe and everyone there in in my prayers.

cathy said...

I hope you don't really feel like you failed him. you didn't! You did everything you could do to save him and make him well. His body was just to damaged to recover.

I started reading you a week or so ago and wanted to let you know, that I am thinking about you and hoping that tomorrow you have a better day.

bridgett said...

My eight-year-old daughter would like to know what she and her classmates might do to make life better for the children that come to your hospital. Do you have any suggestions?

StudentMD said...

I am heartbroken and inspired, in equal measure, every time I read your blog.

I don't pray, because I don't believe in a higher power, but I might send one up tonight for you, your patients and the war-torn planet in general. Just in case I'm wrong.

Chris said...

Dear Holly, Cathy, Bridgett, and Studentmd, thank you for your encouraging words. I appreciate it. I have learned that it helps my heart greatly to share here. It is a benefit to have your good wishes, for my crew and for our patients. Bridgett, tell your daughter that she is so generous to want to do something for the children here. We have many stuffed animals and toys that we try to give to the children who are well enough to enjoy them. I think if your daughter and her classmates want to send a drawing or get well card to injured children or troops it would be appreciated. Just by remembering them and discussing the difficulties they are facing they are making the connections that join us in shared concern for our world community. I have grade school children, and even though I write about some frightening things, I try to write so that with the help of parents, children can understand what is going on over here from my posts. If your daughter or her classmates have any questions, I can try to answer them. Thank her for her generous concern.

Chris

LTC Christoper Coppola, USAF
332 AEW / EMDG
APO AE 09315-9997

christopher.coppola@blab.centaf.af.mil

emergencyemm said...

I love your blog.

You've been blogrolled.

Chris said...

Dear Emergencyemm,

Thanks for visiting. As a former EMT in CT and RI I loved your blog. I've listed it here. Best of luck in your studies and have fun!

Chris

emergencyemm said...

Thanks for blogrolling me!

ChefSara said...

Chris--
Please know you did not fail this boy. Not all can be saved, and you did everything you could! You are providing life and hope to so many people over there who couldn't have it otherwise! Keep up the good work!

Chris said...

Sara,

Thanks for saying that. One thing I had to learn in medical school was that it is the patient who has the disease. We work as a team to seek health, but I am useless if I become paralyzed when death wins. And there are times when death is the best thing that could happen to a person. We have to carry on, but I have a responsibility to the dead and to my future patients to scrape for any lesson that might be there. Bosk described the process as "forgive and remember" : move on to the next human in need, but never forget what went wrong with the last one.

Take good care of yourself!

CC