Sunday 23 June 2013

Little Angel

WARNING: Some may find this post extremely distressing. It's on the subject of Sudden Infant Death Syndrome and contains some very upsetting descriptions. 

I remember when I first started training, being told about all sorts of things that we will see. Some rare, some common and some unheard of. The prospect of the sheer volume of things I would see scared me  but having never seen anything, it was all a big unknown. I didn't know how I'd cope with the shifts, the people and the emotions of what is commonly touted as 'A job like no other'. I was assured that when the time came I'd be with a 'grown up' and all the training would come flooding back. I could only hope.....

It soon became apparent that the training did come flooding back, time and time again. As the weeks, months and years went by more and more things became second nature. My body got used to the shifts (kind of), I got use to the people (kind of) and on the whole my emotions were kept in check. You do get an emotional attachment to some patients from time to time. Some faces stay with you. Some are gone within seconds of leaving them. There is a constant emotional tight rope with me thinking that I'm either dead inside or too fragile to do the job. I suppose that balance is what has kept me grounded most of the time.

We'd been having a pretty non-descript shift. I couldn't begin to tell you the patients I had seen or what was wrong with them. That would be the 'at arms length' approach to ambulance life. The first real detail I remember of this day was my index finger reaching out and pressing 'Green Mobile'. Within a couple of seconds the job appeared on the screen.

"4 months old male, cardiac arrest, CPR in progress"

I felt the blood rush away from my face, my hands became cold and my heart rate doubled. I started imagining everything that could happen next. I pictured the child in his cot, his parents frantic. The only image of the room he was in that I could conjure was that of my own son's room. The thought choked me. Surely, this can't be. It must be an error. He must just be asleep. It must be a false alarm. I don't know why, but this felt different to all false alarms that have come before. This had a strange reality. I knew this was real. Then the radio started ringing.....

"Guys, I believe this is as given, we have another truck and an FRU on way but you are currently nearest. I have also requested the police."

My heart genuinely sank. I couldn't for the life of me remember the resus protocol. I knew it, but I convinced myself I didn't. I was the clinical lead. My crew mate was a student and was equally terrified. I tipped my bag upside down and started flicking through pages of A4 paper with recent clinical updates. I had about 0.3 miles to refresh my memory and then it was all on us. 

We screeched into the road, the familiar waving met us at the kerb. This time it was all the more frantic. All the more desperate. All the more real. The child's dad, consumed with grief, overcome with fear was begging us to do something before I'd taken my seatbelt off. I jumped out, grabbed some bags and ran into the house while trying to find out what had happened. A woman, who I assume was the grandmother was stood in the hallway clutching on to two young children. Tears were pouring down their faces. A shiver ran the length of my body.  This is as real as it will ever get. As I neared the top of the stairs I saw the mum. She was kneeling on the floor, desperately trying to breathe for her beloved baby boy. 

"Please, do something!!" she cried at me. 

Her voice alone broke my heart. I'd never experienced such pain and hurting. I could imagine the desperation and her thought process but without living through it, imagination won't ever come close to reality. 

I looked down at the boy. He laid there lifeless, peaceful, like he was sleeping. He was dead. His short life had come to a tragic end and I knew there was nothing I could do. There was nothing anyone could do.  

"Do something, please!" she wept. "My beautiful baby boy. I'm so sorry, I'm so so sorry."

In that split second I made a decision that I have questioned over and over, ever since. I held the mask to his face, filled his lungs with oxygen and started CPR. I lifted his lifeless body off the floor. With him lying on my forearm and using just two fingers I continued the chest compressions down to the ambulance. My crew mate followed with the bags. The FRU had arrived by now. He saw me rushing out of the house with the baby, and opened the back doors for me. The mum and dad got on board and we left. We had been on scene no more than 2 minutes. I looked at the guy on the FRU and just shook my head slightly. 

As we drove through the streets all I could do was go through the routine of CPR and ventilation. I felt in that moment it was what the parents needed to see. They needed to see us do something. Anything. I struggle with the morality of giving false hope though. Was I prolonging their pain? Who am I doing it for? Was it me who felt the need to do something? 

"I'm so sorry my baby boy, I'm so so sorry I wasn't there when you needed me, I'm so sorry my little angel."

Despite my best efforts, tears started trickling down my cheek. I couldn't help but see my son lying there, imagining what I would do in this unimaginable situation. 

The doors swung open, I picked him up and ran into resus. A small team was waiting. They'd been warned by control we were coming with a patient who was deceased and all our efforts were for the benefit of the family. I handed over the brief history I had. He was put to bed at 6pm. At 9pm, mum went to check on him and he wasn't breathing. Here we are now. 

The doctor told them he had gone. He tried to do so in the most compassionate way he could. Maybe that's why I started CPR. Because I couldn't have that conversation. I couldn't be the one to break that news. News they most likely already knew. Maybe I fell into the trap of having to do something. I don't know. To be honest, I didn't know anything. I couldn't process what was happening. 

I left. It wasn't until I got back to the ambulance that I realised we were all crying. We sat there in silence for a good ten minutes. What could we say? What could we discuss? There is no job more distressing, more tragic and more emotional. What we were feeling however, pales into insignificance in comparison to what the family were going through. The more I thought about it, the less I was able to comprehend the impact this event would have on a family. It literally didn't bear thinking about.

The police arrived and asked us some questions, and then one of our officers arrived. We were told once we were finished at the hospital we could go home if we needed to. We all did. I didn't come in for another week. I couldn't. We were offered support and counselling if we wanted it but I turned it down. I suppose the last thing I wanted was to talk about it. I didn't want to think about it. I wanted another job. I couldn't do this again. Ever.

I did come back. I still don't think I could go through that again. I know there is a chance I will and that will have to be dealt with if and when the time comes. Those parents have to not only come to terms with the loss of their child but somehow be strong for their other young children. The least I can do is carry on offering that false hope where it's needed. It would be selfish to walk away.

You cannot quantify events like these. Saying 'these things happen' doesn't do the loss any justice. I felt like a fraud moping around, feeling sorry for myself. This will be with that family for the rest of their lives. There are no answers that can be given. No meaningful explanations as to why. Nothing will make it better. The words 'I'm so sorry my baby boy' will forever be with me. I will always remember their little angel. I know she did nothing wrong, the doctors know she did nothing wrong, but I also know she will probably take a feeling of blame with her to her grave. I imagine all parents would. I know I would.


  1. I'm sitting here with tears streaming down my face, and from 1 parent to another- You did the right thing. However futile, you validated that mum's efforts to bring her baby back.

    RIP Little Man.


  2. You were right to try, it was not giving false hope it will give the family the knowledge that everything possible was done to save their son. I get great comfort from knowing that passing paramedics went to the aid of my late husband, there may have been no or very little hope but at least they tried.

    Glad to read that you were not expected to continue your shift following this traumatic call.

  3. Life is strange and cruel. I am a Police officer with 12 years service yet have tears running down my face. My six year old son is eating his dinner and asking "Whats wrong Daddy". How can I tell him about the fragility of life?
    Ella I take my hat off to you and your colleagues who deal with this on a daily basis.

  4. Heartbreaking, I think you did the right thing, and how brave you are to know you could face this any day. You are amazing.

  5. I can't begin to understand what pain and anguish the parents must go through when this happens..

    Thank you for being human and helping the parents in that awful situation!

  6. Do you mind if I write a response with my memories of the jobs I did later?

  7. Life is so precious, we should treasure every living moment, speaking as a mum,with3 girls, who also lost a child and a husband, we try not to worry over trivial things that don't really matter

  8. Thank you for posting this. As you know my daughter died on the second of february this year. I am certain she was dead when we found her yet the ambulance crew and my husband tried everything they could to save her, to bring her back. I will always be grateful for their actions that night. They did all they could for my baby girl. I hoped with all my heart that something they did might work. It didn't. It never could have but I am so thankful that they tried. Thank you x

  9. As a staff nurse on paediatrics I saw the death of little ones more than I ever imagined, and the last time was no easier than the first to comfort distraught parents. Nothing, but nothing, can prepare you for that awful scenario. You did right, for the parents sake.

  10. As a father who very nearly lost a child at 3 months old, it brought back some pretty grim memories, although I was very lucky and my daughter pulled through and is now happy and healthy.

    Read this whilst on call as a First Responder and had just reached the end of the blog when I was turned out to a child, "limp floppy and unresponsive............................." turned out to be an elevated temp, and previously diagnosed infection.

    it is only by blogs like this that the general public has any idea what the Ambulance Service and its staff do day in day out, sometimes they move to tears, sometimes they make you rage, but above all they provoke thought, please keep them coming

  11. i think the empathy you show and the hurt you feel proves your worth as a paramedic! stay strong x

  12. I too have tears streaming down my face. My son had apnoea as a baby and stopped breathing on numerous occasions and was twice taken to hospital by ambulance. On both occasions he started breathing by himself but he wore an apnoea alarm for one year. What you have described was my worst fear for a long time and even now I still have nightmares. I can say hand on heart that what you did was the right thing. The little boy's poor Mother would have known he was dead, but like all Mothers she could not and would not accept it; a mother will fight and fight for her children and will do whatever it takes. She would have wanted you to do the same, anything and everything possible no matter how futile. My dear son is now soon to be 4 years old and I am grateful to all the paramedics and hospital staff that have tended to him over the years. And I thank you too for being full of compassion and strength and for doing such a difficult but oh so important job.

  13. This is a scene that every parents prays they never have to witness. I am a mum to a healthy and happy 10 month old. Reading this sent a chill down my spine, reduced me to tears and had me straight in her room to cuddle her. I commend you for what you did for that baby and for his parents. Those parents will know that you did absolutely everything that you could for that beautiful boy and in years to come this will bring them comfort. You have a tough job and days like these I can only imagine how hard it is to go back. But in doing so you help save even more lives and that is what you should hold on to. x

  14. Had similar situation twice...not easy, still can remember the calls very well. You did the right thing. I still sorta question the times we did not start CPR on a self-inflicted GSW and a cardiac arrest in a vehicle that was upside down in a ditch. My brain knows we couldn't do any thing, but my heart still wonders.

  15. Bawling my eyes out, so so tough Ella x

  16. I've been where you were - several times and it never gets easier but you did right! Don't second guess yourself. Your instincts were spot on.

  17. I have no children and I don't have anything sanguine to say, except to ask where the tissues are. *sniff* It seems to be raining in my bedroom.

  18. You are a wonderful human being, may God bless you.

  19. A close friend lost a baby at 8 months to congenital birth defects. Although I think the hospital went too far in their heroic measures, I know the family needed them for a while anyway to know that they had done all they could. I am sorry for your loss and grateful for you being there for him and them. By the way, my call like that lingered in the NICU for four months before passing. It is hard to lose them whenever they go.

  20. Dear Ella
    Thank you for sharing the anguish of your call. Years ago as an emergency department nurse I participated in something similar - the ambo had picked up a 4 year old who had been hit by a car in front of his family. They raced him to us and had called for the helicopter to meet them in our ED. The child was the same age and size as my son, and I kept seeing my son's face on his body.
    When the helicopter got there, the flight nurse, who was a friend asked me "why are we flying this dead baby?" out of earshot of the commotion in the rescus room. I said "so the family knows we tried everything". She thought for a second and said "OK, I'll pronounce him as soon as we take off so they don't get charged".
    Your statement "I will always remember their little angel" is so true. I don't know why we are privileged to be there for the families in their ultimate grief. But we are, and what we learn as we care for their angel, their Mom, their Grandad will help us do our very best for the next one and the next one.
    I love your blog and look forward to it.
    Thanks from this getting pretty old Nurse.

  21. As a death investivator in the States I encounter similar gripping but not so urgent emotional situations involving young children and their parents. Being as diverse as we are where I am, I often do not speak the same language of those I serve. That being said, there are times when a translator is appropriate but then, there are other times, when words in ANY language aren't good enough.

    One case in particular haunts me even years later...... The woman's toddler died an accidental death in the care of others while she was at a funeral. We met at the hospital. From the outset, even though I knew a little of her language our communication was at the most basic human level that two people can be at. I wasn't an investigator and she wasn't just another "next of kin". We were women...mothers.....mothers who did nothing more than live for our children. The ONLY difference between usually was that mine was at home asleep and hers was deceased in her arms.

    When it came time for me to leave, I had to take her baby with me. The only way I could really get her to even let me get him in my arms was to basically strip myself bare her who I REALLY was. I was asking her to give up her greatest love.....her reason for living. He was already dead and now I wanted her to physically let go. Was I crazy?? She had to trust me in order to let me leave with him.

    I put my hand in hers and looked her in the eyes as if to say "I will care for him as if he were mine. I promise." She held my gaze for several moments, her grip on her son tightening....then releasing. I slowly cradled him in my arms, away from her but never losing eye contact until her husband lead her out of the room as I turned my back and put my head down towards the baby.

    I have struggled with babies since then, but they have all become mine. Someone needs to be the one on the otherside who loves them and as long as I can keep it up, that will be me. The day it doesn't bother me is the day I walk.

  22. My sister lost her beautful baby girl, Macy Nicole eight years ago to SIDS. She was 15 weeks old. The first responders and EMTs did the same as you, and continued the efforts started by my sister, even though they knew Macy was gone. We will forever be grateful to those wonderful people who had my family's emotions in their mind at that moment. The first person to get to the scene was a neighbor who was a volunteer fireman. He later told my Dad that when he walked in , he knew it was futile, but continued for my sister. He was only 18 and I can only imagine how hard it was for him. Thank you for the awesome job you do. I am an RN and deal with death but definately could not do what you do.

  23. Tears are rolling down my cheeks. This is very touching. I am glad that you could get the time off and also offered counseling. It is a hard part of the job. As a mother, it makea the job easier but so much harder! I like that I can console the kiddos and make them feel safe but when I have to take them away from their parents, I feel anguish and sadness. This job is so hard but there is a reason for everything. You did everything I would have done. There is nothing wrong with crying. We are humans and I believe that letting family see you cry is the best for them, it reassures them, lets them know we care and are doing everything and that we feel for them. Sometimes actions speak louder than words. Especially when words are hars to say in times like this! Keeping you in my thoughts and prayers!

  24. Office is smokey tonight. Certainly stinging my eyes. I have three children and cannot for one moment think of the anguish such parents have to go through. I haven't had to deal with dead children but have arrived at a couple of RTCs before ambo have turned up. You can see that the patient is dead but you get on and CPR anyway. As a number of posters have said, if nothing else, at least you are giving it your best effort to help the patient, however futile. Whether we do it for them or ourselves, I guess we never really know. I like to think that I am doing it as much for the family as for the patient.
    At least your management offered you time away and counselling. The most that we have ever got is me getting my team together for a debrief cup of coffee and a fag for the smokers.
    Keep up the good work.

  25. While i realise you don't need my opinion, i feel you did the right thing and exactly what i hope i would do if put in that position.
    Hope you're doing ok Ella x

  26. Thank you for sharing your story. I had a similar experience and then the following day, I had a 16 year old girl VSA. The 16 year old was much more difficult because there was a chance she could have made it if someone had checked on her. So incredibly frustrating.

  27. I am a newish reader to your blog. Thank you for sharing. X

  28. I read this with tears in my eyes but it made me brave enough to ask the paramedic in my life if this had ever happened to him and not surprisingly it had - early one morning about 6 years ago. HIs tears even now just made me love him a bit more and respect what you do even more x

  29. Thank you for your words. It is so important to hear how sudden infant death affects every person who experiences it.

  30. This had me in tears. So heart felt in how it is written. You can really feel your emotion from it xx

  31. Cannot control the tears. You did the right thing. All I'd want is to know everyone tried their hardest for my child. Well done for going back, the world needs people like you. xx


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