Yesterday afternoon, my husband and I were in our kitchen drinking tea with our neighbors. All of a sudden, Josie, my three year old, runs up from the basement where all the children were playing. "A table fell on Izzy! Quick! Come down!" I immediately started to make my way toward the basement door, when in it appeared my baby with so much blood on her face, you couldn't see her face. She stumbled to me and then laid herself down on the kitchen floor. The blood was pouring our of her nose to the point where she was actually choking on it. Blood coming out of her mouth, dripping into her ears. Hair - bloody. Eyes - bloody. Puddle of blood on the kitchen floor. I have worked in the ER and PICU and I can tell you, this was quite possibly the bloodiest child I had ever seen.
After cleaning her off enough so that she could breath, I carried her to the car. My husband held her while we drove at a certainly illegal speed to our local hospital. This is where things slowed down and I started to think, "This must be what it has been like for all of those parents..." Looking back on it, everything happened incredibly fast - from getting taken back, to IV placement, to head CT, to getting transferred to a higher-level care hospital. Living it, every step was an eternity. I couldn't understand why the radiologist couldn't read the CT faster. Once we found out the result was bad, the slowness got worse. Didn't anyone understand how sick my baby was?? Why couldn't the Hopkins people call back faster? Why couldn't the ambulance get there faster? Once at Hopkins we spoke with 2 ER attendings, 1 ER fellow, 1 resident, two plastic surgery fellows, a general surgery fellow, and a neurosurgery fellow:
She had pulled on a 200 pound work bench, metal with about a 2 inch slab of
wood on top. She was trying to move it. It toppled and fell on her face, bashing it
in and knocking her onto the carpet-on-concrete floor. Her 6 year old sister had
managed to pull the table up and get her out from under it. Izzy did not loose
consciousness but she did forget why she was trying to move the table. She has
no medical problems. She is allergic to amoxicillin...
Same story over, and over, and over, and over again.
Getting these guys to come to a consensus took over an hour - actually not bad considering how many attendings there were to call and how many people needed to look at her CT scan. This was literally the longest hour of my life. ALL I wanted to hear was "She will be ok. We see this all the time and she will be ok." Just that. What made it worse was that my husband was clearly experiencing a very acute form of PTSD and wouldn't talk. I think if he tried, he would have just burst into tears.
Finally, a verdict came. The CT was not as bad as initially thought. She did not need to go to the ICU, just the regular floor for frequent neurologic assessments and IV hydration, since she was not allowed anything by mouth in case she deteriorated and they had to intubate. She would go to the OR to repair the multiple broken bones in her face in a routine fashion. The air that got into her brain was not a danger. It was not an emergency. My favorite part of the night was realizing that the neurosurgeons might actually have been bored with her head CT. They did, in fact, see this all the time, only no one had told me. As a physician mom, your child being a boring patient is the next best thing to them not being a patient at all.
So, here we are, my baby sleeping all the time, trying to heal her bruised brain, face, and nose. Last night she was throwing up dried blood every couple of hours. Today, she has started to sip clear liquids and had a cherry popsicle. I know we have a long road. Concussions of this severity take several weeks to heal. We are just beginning the journey of tests and doctors appointments. Thankfully, we have had an outpouring of support by family and friends. They will make the journey bearable.
For those of you who might have been reading this blog for the last couple of weeks, you know my grandmother died December 17th. Then on December 31st, our minivan was hit by another car on the highway. When Isabel and I went on an "exploration walk" on our snow day last Friday, I was thinking, my God I am so lucky she is ok and was terrified that the final event in the trifecta of badness that always seems to happen, had not happened. Well, it happened. The last shoe dropped.
As with many challenges in life, you wonder why they happened and you hope you come out a better person at the other end. I hope I will be a more patient mom and a more empathetic doctor and pray the cost is not my daughter's mind. Something good has to come out of this.