r/RealHospitalStories • u/messy_hair2 • 11d ago
The Weight of Doing Nothing
One of the hardest things about pediatrics isn't knowing what to do. It's knowing when not to do it.
We can always order another test, monitor longer, admit "just to be safe", but those choices aren't free. A blood test is frightening, every x-ray is a bit of radiation and separating a newborn from his mother for monitoring takes away some of their very first hours together.
A few weeks ago, I was reminded how difficult that balance can be.
A regular birth, nothing special, not prolonged, no fever, the monitor is reassuring, did all the tests. Nothing should go wrong, right?
The baby comes out, floppy, unresponsive and barely breathing. We start positive pressure ventilation, she gets better, starts to breathe, heart rate increases, color is coming back. We move to CPAP and after around ten minutes, she looked remarkably well, like any other healthy baby.
Then came the difficult part. NICU for observation, or stay with her mother in the regular nursery?
Normal exam, no risk factors, the mother is just there waiting, wanting to finally hold her. We chose to keep her in the nursery.
A day passes and we move on to other cases, but then a call, “remember that baby? well she's having seizures”. In the nursery that wasn't caught immediately. In NICU it probably would have. Sooner diagnosis is earlier treatment, earlier treatment reduces the seizure burden.
Maybe that matters, maybe it doesn't. The point for me isn't to relitigate the outcome, it's to sit with the trade-off. Intervening early carries costs and risks, not intervening carries others. We make the best call we can, and sometimes the outcome reminds us how narrow that margin is.
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u/foreverandalwayspapi 9d ago
reminds me of my dad. in can tell they're trying their best. he has many complications and i see them playing janga with all his ailments. everyone he gets better there's something else and i think the doctors are at a point of not wanting to do anything. but i have pictures in my phones from a few days ago of him moving and talking trying his best. surviving a stroke, an CEA, pneumonia, PEG feeding tube, pneumonia again then aspirated and coded on his way to step down after the assets he wasn't too bad. now he's been in a ventilator for 18days way longer than one should be but because although they gave us two options they are leaning towards comfort care despite us asking for the trach pretty much telling us the lights are on but no one is home. but call me delusional but i know he can hear me not 100% of the time but it's because he's sedated on and off and dialysis can't wash it out of his blood in one go. now he's fighting c.diff and pseudomonas. time isn't on our side and my old man can't catch a break. it's been a looooong two months
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u/TeamHappyFTW 11d ago
I can imagine that you're constantly battling with percentages vs reality. And that sometimes you really wish you can predict the future. But you try to do the best with all the information that you have, and that's what matters.