i've put off posting about a patient i once had in paediatric surgery because my writing could never justify how i really felt about him, but i suppose i should at least try.
when i rotated through paediatric surgery, there was a memorable patient. let's call him k. when i knew him he was 2, but his story started long before that.
k was one of a set of twins. for whatever reason his mother favoured the other one. this means she lavished what she could on his brother. what she could lavish was nothing more than food. k became very malnourished. around roughly their first birthday the mother decided she was tired of k, but how do you get rid of a baby? she decided to poison him. she gave this poor malnourished child something to eat that was supposed to kill him.
i still don't know for sure what she gave him, but it was amazingly corrosive because it burned his epiglottis almost completely away, it destroyed the opening to his trachea and it essentially destroyed his esophagus. he had a tracheostomy through which he breathed, a gastrostomy through which he was given food and because he couldn't swallow, there was a constant stream of drool running over his lower lip. he also could only mannage a strange low pitched moan if he tried to make a noise.
when i worked there, he had been in hospitals for a full year. he was a delightful child. i started work every day by giving him a hug. i figured love was something he hadn't seen too much of in his short life and it was something i could do for him. he seemed to enjoy it.
then one day, while we were in the morning meeting, we got a call that little k was dying. we rushed down. in the ward we found that he was blue and had stopped breathing. my senior colleague ran up to him, ripped out his tracheostomy tube that was blocked and quickly inserted a new one. he quickly recovered. i did not.
such a simple problem like a blocked trache tube had almost meant his death and that in an academic hospital. what chance did he have for the future? i considered adopting him then, but after much thought decided that if i wanted to adopt every child that i met in my profession that had a raw deal in life i'd have to start an orphanage and drop aspirations of becoming a surgeon.
time went by as it tends to do and my time in paediatric surgery came to an end. i saw k a number of times because i often went to his ward to give him a hug if i had a moment. then one day when i got there i heard he had been sent back to his referring hospital. he was supposed to follow up again in one year for a more definitive surgical repair.
about a year later i asked the senior colleague who had saved his life when i was working there what happened to little k. without batting an eye he calmly told me he was dead. his trache tube had blocked in his referral hospital. there was no one there who knew what to do and he suffocated. that was the end of k. the colleague went on to say that it was probably better because his life was doomed to be miserable etcetcetc. i just felt sick.
to this day i can't forget little k. i still wonder about the permutations if i had adopted him.