A true story from my blog 'Forgetfulness": A case where a mother forgot...

The inspiration for the fiction story told in the blog 'Forgetfulness' was a very sad medical case I was involved  in - twenty four years ago during my first resident year in a major teaching hospital.  It was such a sad case that I will never forget it.  I was so sad for the child who drowned but also very sad  for the mother who blamed herself for the child's death.


The year was 1990 and I  was a first year resident medical officer (RMO) working in Paediatrics in a major teaching hospital in Adelaide, South Australia.

I was in the A&E department, Casualty as we used to call it, when an  ambulance officer radioed in  to give an ETA (expected time of arrival) for a priority one, or code blue, case - an emergency.  The ETA was five minutes. 

The Trauma team call was activated and specialty consultants and registrars from  many different departments in the hospital rushed to  A&E.  They now waited in the treatment room:  paediatric physicians, surgeons, Intensive care specialists and the A&E staff. 

The case: a two year old girl, near drowning in a bath.  The child was not breathing and she had no pulse.  The ambulance officers were performing CPR (cardiopulmonary resuscitation) en route.

The ambulance arrived.  The small child lay flaccid on the trolley as staff moved at lightening speed all around me.  I was a very junior doctor and so I stood out of the way of the senior doctors, at the back of room.  I was ready to do any menial tasks asked of me.  Requests such as rush blood samples to a lab - which meant to run with the pathology specimens to the labs which were a distance from A&E, put labels on the  pathology samples handed to me, call the radiologists and write the request forms and so forth. 

I caught a glimpse of the  distraught mother when the ambulance officers arrived.  As ambulance crew ran up the A&E corridor to the treatment room with this critically ill child she had run along beside them.

She was a medium build, she had dark hair  pulled up into a messy bun and her face was streaked with tears.  Her eyes were swollen and red from crying.  She looked terrified, dishevelled, grief stricken and so guilty of the crime she had committed. She had left her child unattended in the bath for a few minutes when she left to answer the phone.  She had stayed talking on the phone for five minutes she told hospital staff.  She had forgotten to return immediately to the bathroom as her two year old daughter and her four year old daughter had been left to  play together in the bath.

The child's mother was quickly taken away by other medical staff soon after she had arrived.  She was taken to a quiet room  away from her child  so that the doctors could work on her child without any distractions and so she would not have to witness her child in this awful room; doctors working frantically and doing  whatever it took to try to save her child. 

I stood watching and waiting to help.  I watched as the medical experts around me sprung into action.  They worked like a single amazing machine - together as a team, professional , skilled and so very experienced and fast.  They were desperate to try to save this young life. 

I can still see the child now.  She was such a pretty little girl.  She looked like she was just sleeping - peaceful.  Her hair was still wet from the bath when she arrived.  It fell down over her shoulders and upper back  in wet, blond  ringlets.  I imagined that only half an hour earlier this little girl was happy and healthy and playing and laughing ... and now... this. 

The doctors managed to get the child's pulse back.  She was put on a ventilator and then sent off to the ICU (intensive care department).  However, the doctors knew what would happen next.  Drownings almost always result in only one of two things: death or complete recovery.  There is rarely an in-between recovery from drownings.  The doctors knew which outcome this would be.  Their sad faces watched quietly as the little girl was wheeled from the treatment room.

When we quietly returned to our own paediatric ward the senior registrar told us what would happen from here.  The child was thought to be brain dead, he said, and she would be put on a ventilator until the next day as is the policy.  She would then be tested again fully by the ICU specialist doctors and if as expected it was confirmed that she was brain dead - which means the cortical or thinking part of the brain has been deprived of oxygen for too long and it  is functionally dead and only some vegetative functions are left such as functions to maintain a pulse - then this would  be explained to the parents.  The parents would then  see that everything that could be done to try to save their child had been done and the ventilator would be turned off. 

Waiting the 24 hours would allow the parents to more fully  understand that no-one stopped trying to save their little girl too soon.


As my colleagues and I  sat having coffee  later that day still feeling so very sad about the drowned child I found it especially sad to think that had the mother known CPR (cardiopulmonary resuscitation) then she would have been able to perform it on the  lifeless child she had  pulled from the bath that day.  It was possible that CPR performed during the 10 minutes it took for the ambulance to arrive may have saved this child.  As it was she had sat helpless in those crucial early minutes while she waited for the ambulance. 

I have never forgotten that case, that beautiful little child, her poor mother and that sad day.




I mentioned in my blog that I would advise everyone to learn CPR - before you need it.

It is best to - hope for the best ... but plan for the worst.