Ultimate Sadness

My friend Mo is a surgeon in San Pedro, California. Much of the time he loves his job and is happy for the opportunity to help so many people.

Sunday was not one of those good days. With his kind permission, I am going publish the email he sent me yesterday. If the first line is something that is very upsetting to you then you should not read further.


"I just finished sewing up a dead boy.

I pronounced him dead at 10:34 PM. It's now 11:27 PM. I know I won't be able to get to sleep for a long time. I feel like I shouldn't.

I'm a trauma surgeon, down here at St. Mary's. I was sulking in my call room on Palm Sunday because I missed yet another important moment in my 5-year-old son's life. A tarantula crawled all over him at his best friend's birthday party, and my wife had e-mailed me a glorious photo of this big, hairy arachnid on my son's face.

The phone rings, and I am summoned to the ER for a "gunshot wound to the chest". That's bad, but around these parts, sadly not a surprise. Then the ER secretary adds, "...in a 12-year-old." That changes things a bit.

As I hurry down to the Emergency Department, I play out several horrific scenarios in my head...a mental exercise in preparation for what certainly was to be a difficult situation.

I arrive to a room filled to capacity with doctors, nurses, techs,  volunteers, firemen, policemen, and paramedics. The strictly medical people are swarming around an impossibly small figure, in a flurry of needle sticks in search of a vein, monitor-pad placement in search of a vital sign, stethoscopes vainly searching for a breath sound or a heart beat. The non-medical personnel had formed a concerned and curious peanut gallery. One ER doctor blurts out the important points, "GSW to the chest, pulses in the field but..." while another ER doctor is prepping this small chest for an ER thoractomy.

In English, an "ER thoracotomy" is where you flay open a chest in a soon-to-be-dead  patient, in the hopes of finding a hole you can quickly but temporarily fix. Once that is done, it gives you a chance to give the patient necessary things like blood and IV fluids (where they now will not simply flow out of those repaired holes), and get him to the OR so you can fix him properly. It is the trauma surgery equivalent of a "Hail Mary" football pass. This is not a "difficult situation", this is a nightmare.

The ER doctor sees me, and literally hands me the knife, as if to say, "Here. It's yours." I think the kid is dead, or if not dead, then he certainly is "unsalvageable", which is a horrible word to use for a human being. I don't think he's fixable. However, if he is to have any hope of survival, the ONLY way to save him is to crack him open and try to plug up the holes. Cracking open a 12 year old boy is going to tear my own heart in half, I think to myself, but this is part of what I do, so I slip the gloves on and take the knife. There is precious little skin to cut through, and I'm in the chest in a few seconds.

His chest cavity is filled with blood, which spills out of his chest like a macabre waterfall to the floor. There's a shredded tear in his lung, and a big, ragged hole in his heart. All the IV fluids that my associates are pouring into the patient are flowing out this hole and on to my shoes. I put my finger in this hole...such a big hole in such a small heart...but blood and fluids still flows unfettered. My other hand finds another, larger hole on the other side of his heart. My fingers touch. His heart is empty. Mine breaks.

His family is brought in while I am bathed in his blood, as "studies have shown" that this is better for everyone involved, to be present as the end nears. I scramble for a way to just stop the bleeding. I just want it to stop. It's spilling over my hands on to the gurney. His mother is begging me to do what I can. I know I can't do anything. She tells me to take her heart, and give it to him. I know that's not possible, and she knows that's not possible, but she could not be more serious. The first ER doc is sitting alongside the mom, gently telling her that we've done everything we can do. His mother looks at me. My hands are still in the boy's chest, trying to do something, anything. In her eyes, I see a soul that I am about to crush with a little nod of my head. I do so.

As the howl of unimaginable grief shakes the entire ER, I am filled with anger. Why do we still sell guns in this country? What is this child doing on the streets after ten o'clock at night? Why are we killing our innocent young soldiers overseas, and ignoring the merciless gangbangers...terrorists in their own right...that are invading our streets here at home? I try to put these thoughts away, because now, in front of his family, I have to sew him up. I have to close this huge gash in his left side, that I made.

I place the first stitch, and as I'm tying the knot, I look at the boy's face. He's small for 12, not that much bigger than my son Ben. All the adrenaline is gone. My shoulders sag. I feel myself start to cry, and I know that I can't stop it. I have no way of hiding because literally everybody is looking at me, including his mother, and my hands are busy, so I can't wipe the tears away. I make eye contact with the mom, and whisper "I'm sorry." I finish closing his chest up, and shuffle off to the sink to wash this child's blood off my arms.

I sit down in the doctor's area, to start filling out the pointless paperwork. Several nurses and doctors come over to offer encouraging words, or a consoling hand on the shoulder. I want to quit. I don't want to do this anymore. I want to quit because that means I can go home. When I go home, I can quietly open the door to my son's room,  and sit on the floor right next to his bed. I'll watch him sleep, that blissful sleep only found in young children. I'll watch him for hours, and tell myself how lucky I am to have him in my life. I want my son to put my heart back together.

But I can't go home, as I'm on call until 8:00 AM. I can't quit. Tomorrow I have patients, surgeries, rounds...the usual stuff. Hopefully, I'll be home for dinner. When I come through the door, I'll hear his cheerful yell of "Daddy!" and he'll jump into my arms. He will in all likelihood never know how much that moment means to me, but it is precisely that resuscitative energy that will restore me. To keep coming back to this sort of work.

I will sneak into his room after he falls asleep. I'll give him an extra kiss goodnight. And then, just maybe, I'll close my eyes."

Thank you Dr. Mo for the work that you do even when you can't manufacture miracles and thank you for giving us a glimpse into a small part of your world.

Comments

[HeatherMichelle]

Wow, Bean. I do not have the words needed to express how this makes me feel. Thank you for sharing and thank Mo for everything he does.

[Raul]

I heard about that story on the news as I clearly remember the 12 year old gunshot victim. Didn't know Dr. Mo was the Doctor in charge. I don't know what this world is coming to.

Guess I will have to try and prepare myself as well because I my new position involves Cyber Crimes against children.

Don't take life or your kids for granted.

Being a Dr. is never easy. On anyone. My mother was a pediatrician and even though she didn't have to deal with GSW to the chest, it was never as glamourous as we might see on TV or the movies, especially when the phone rings at 2am and you must drive down to the hospital to be present for a C-section.
No. i wouldn't wish that profession on anyone. Especially when you have to sew up a 12 yo. But I am grateful in so many ways that someone was motivated to go to medical school and deal with things I want no part of (blood on my shoes, a distraught mother, a dead boy) Yes, thanks to Dr. Mo and the thousands of others like him.

[Lynne_T]

Thanks Bean and Dr. Mo for this story. I too am horrified of all the shootings that have been published in the paper recently. I don't understand these people. I wish these gang people would go away. I agree with Dr. Mo about the erg to bring the young men back from Iraq to deal with these gangs; but know that will never happen. So since less. Wish I can say more......

[bruin]

Heartbreaking stuff. My 12 yr old has a team mate who was jumped on his way home from school on Friday. On residential South Bay street among 800k homes,three much older boys blindsided him, knocking to the ground and one repeatedly kicked him in the head. The end result was fractures to both orbital sockets, fractures to both sides of the jaw and a nose nearly torn from his face. I looked at my own son and teared up thinking of this poor boy and his devastated parents and all the pain and surgery in his future. What are we doing as a country that our children are growing up so callous and psychotic that they can inflict such pain and death on each other?

[Vic Rattler]

Yeah, but remember guns don't kill people, so...

[Ken]

Having a child of my own, this just cuts to the bone (absolutely no pun intended). Trauma surgeons in the military train in trauma centers throughout the US because of the similarity to battlefield wounds you can only find here. Speaking of which, 5 years in Iraq…

[Diane]

Thank you for sharing this story. On Tuesday, the US Supreme Court hears oral argument in a case involving the constitutionality of Washington DC's gun control laws. Given the make up of the Court (thanks W!), it is likely they will find such restrictions invalid, and the few gun restrictions in this country will be gone.

[db]

-Thanks to Mo and people like him
-Thanks to Bean for reminding us what is truly important
/that is all

[liz]

If we don't help our kids, who will? They can't help themselves! It's part of the reason I've been vlunteering at CHOC Hospital in Orange and also at the local Ronald McDonald House. I love seeing the families being able to go home with a child who's not sick, and who could be fixed. It's hard to watch the families leave when they leave to go to funerals for their own 6mth old little girl, or for the wheel chair bound 17 yr old guy who didn't make it either.
I could never be a doctor, but i give much love and appreciation to those who can.

[Erin]

This post brought tears to my eyes....

[Rosie]

I am a mother of two boys and your email brought tears to my eyes. I guess we take for granted the hard work of doctors. My thoughts and prayers are with Dr. Mo and to the family of the young boy killed. Maybe we shoud have the Supreme Court read your blog and it may help them in their decision about gun control.

[brother john]

It's a heart-wrenching story with plenty of grief to go around. This doctor and others like him are doing the work of angels and I'm thankful for them.
There are times to put politics aside and just be human. This is one of them.

[Housewife]

Tears falling on the keyboard...and although I live in a safe city, I want to run to the high school, find my boys and hold them tight. Prayers to Dr. Mo and heartfelt thanks to Bean for sharing a special gift - the gift of opening eyes and hearts.

[Rob Perkins]

I couldn't agree more with Rosie's statement - if this blog was read out at the Supreme Court it might...just might, make those in power re-think the whole gun ownership laws. Someone further up this blog made that statement that guns don't kill people etc etc and this drives me nuts. Of course we know that, but it doesn't remove the fact that the US is full of stupid people who choose to shoot 12 year olds. If ownership of a gun required extreme background checks, intelligence tests, you name it...every test possible then maybe the number of dumb-asses who own a gun might be drastically lowered. I have a 4 year old son and reading Dr. Mo's email damn near broke my heart too. His is a noble profession that very few people have the ability to perform and with the right choices made regarding gun ownership we can only hope that Dr.Mo will have to perform this type of surgery less and less.

[Karisa]

I heard about this young Long Beach boy on the news...I was so angry. God Bless Dr. Mo and his huge heart. More physicians/surgeons should have his bedside manner and caring. God rest that poor little boys soul...he didn't deserve to die so young and in such a senseless way.

[Ana]

He was only 12 years old. He hadn't any time to live. He should be riding a bike, playing ball with his friends, finishing homework or simply worrying about what he is going to have for dinner. My heart breaks, yet again, over a life that was loss for no good reason. Thank you Dr. Mo for all you do, your compassion is wonderful. Thank you Bean and Dr. Mo for sharing.

[TandJ]

I don't think it's about gun control.
It's about being raised right.
Value life, value education.
Value doing the right thing.

[Edmund F]

I hate people. They Suck.

I hope God/Karma/whatever fate you believe in blesses Dr Mo a hundred times over. I will not be sharing this with my wife, as she has enough trouble wanting to bring a child into this world.

Bean thank you for your blog and this post. It reminds me that nothing is beyond desecration, not even a 12 year old’s life. It helps me see people like Dr Mo trying like hell to make this life livable,

Give us a Tater Tot Wednesday. We need a ray of sunshine after this post.

Thanks,
Nate

[me!]

wow....maybe I should have waited to read this at home cuz now my lunch is over and I'm a mess! =(

you seriously have to be thankful for people like Dr. Mo b/c there's no way in hell I would ever be able to do what he does....you're an amazing man in my eyes Dr. Mo!

and you know, it's stories like these that just claritfy how I don't want to bring another life into this messed-up world we live in! I know that may sound so horrible but it's the truth. I look at all of these innocent little children when I go with my dad on the weekends while we do their parents taxes. here are their parents freaking out cuz their house is on the verge of being foreclosed & talking to my dad on how they can solve this and all a little boy wants to do is roll a ball back & forth to me. That was his only concern & he was just so happy! he has no idea how it's brutal out there & that's what breaks my heart.....

me =(

[Melissa]

Thank you Bean, reading this email gave a much more human take than the article I read about this shooting.

[Boogie]

What makes this situation even more difficult to handle is the all to common reality that many of the injured victims we see in the emergency room do not have medical insurance. The physician will not receive compensation for his efforts and may even be sued by the family for malpractice. Go figure. That's what we get for trying to help people.

[K]

This just breaks my heart....

[Geo]

Religion teaches us that we live on a broken planet. I think it would be hard for even non-believers to disagree.

[Gil]

I don't know if Dr. Mo will read any of the commnents but if he should then this is for him:
Sir, you're seemingly a kind person in a very difficult position. I cannot imagine being is such a position nor do I ever want to be.
I do not have children of my own but I value life and you hit it on the head. Why was the child out at night by himself? Not a question you can ask at that given point in time.
I extend good thoughts to you and your efforts to preserve life.

[Shae]

Dr. Mo is an angel. I hope that Dr. Mo's son reads his email one day and knows how important he is and how much love his father has for him. Maybe if this 12 yr old or the person who shot him knew how important they were to someone they would've lived another life.

[patsy]

made me cry :[
cant even type...

[Jimmy Hoffa]

Yes, this article broke my heart, as I have 2 young boys. But what also breaks my heart are people like Nate who start out with "I hate people, they suck". What kind of statement is that? You may hate the person who killed this boy, but to make a blanket statement like that is ignorant. Maybe a little less hate towards mankind, Nate, you think?

[LA]

I'm a medical transcriptionist at another big hospital/trauma center in LA County (not too far from the one where Dr. Mo works). Unfortunately, these stories aren't as rare as we'd like to pretend. Sometimes when the doctors dictate, I can hear the screams of pain from patients and bystanders, it's heartbreaking.

I remember one time one of our ER physicians had to tell a mother that her young son didn't make it. Mind you, the physician was weeping as he dictated this. The mother literally passed out and fell to the ground upon hearing the news.

Much love to Dr. Mo and his commrades.

[mg]

wow, that was just really sad.

[Sofia]

It saddens me for this mother but it also helps me trust doctors because in the end they are human too. He too feels our pain although we are just one more patient to deal with. May Dr. Mo continue to battle his desire to quit and may he continue to have the sensitivity with every wounded child or every person that comes his way. Thanks for Sharing Bean.......S~

[Jeannen]

Thank you for sharing. We're all very fortunate for people like Dr. Mo.

[Fleiter]

We sell guns in this country so people can defend themselves against thugs. It'll take 30 minutes for the police to come to your house and investigate a break-in. So let me ask you, what happens if one of the ridiculously violent gang members who killed this kid breaks into your home with a gun? You die, that's what, unless you have a gun. There ain't nothing like a good 12-gauge shotgun to make a gang member leave your house. Remember, if we outlaw guns, the bad guys will still get them. Where does that leave the law-abiding person: At the mercy of thugs. Don't blame the guns for killing this kid. Blame the bastard who shot him.

[Shae]

Hey Bean, just saw Dr Mo on TV. This story is the lead story on the 10pm news in LA. It gives me a little hope that there are people in the media that have hearts & souls, and who want to show the far reaching consequences of these senseless gang murders.

[Julius Marx]

This blog should come with a stronger disclaimer: If you're a parent don't read this at work unless you want to be reduced to a simpering weeping puddle of goo in your office as your coworkers stare blankly at you.

It's true "guns don't kill people" ... Jackasses with guns kill people. Take away their guns and it makes it so much more difficult and more personal to have to take a life. Maybe said jackasses would have to think twice about their choices to take a life if they had to work a little harder than just aiming and wiggling their pointer finger slightly.

As always your mileage may vary.

Thanks to Bean for posting this and Doc Mo for letting him. You're in my prayers sir.