This is a story about my little angel, Vincent Benjamin.
Vincent Benjamin was born premature (only 33 weeks) on August 26th, 2010 at the city's government hospital. The institution lacked the facilities to support and sustain his life. Thus, his parents decided to bring him to the hospital where I am currently working.
Upon admission, the doctors found out that he had Esophageal Atresia, a case in which the child's esophagus doesn't connect with the stomach and ends up in a pouch. Also, he had Tracheo-Esophageal Fistula. A normal person's trachea (the breathing tube that connects the nose and mouth with the lungs) doesn't connect with his esophagus (the swallowing tube). With little Vincent Benjamin, these two tubes were connected so food or milk can get into the baby’s lungs when he swallows. This can cause breathing problems, aspiration, and even pneumonia.
*The second photo labeled Type B shows how Vincent Benjamin's trachea and esophagus looked like.*
Admitted on September 3rd at our unit, he was intubated and put on a CPAP (Continuous Positive Airway Pressure) set up, a ventilation therapy in which compressed air, at a desired pressure, is delivered to the lungs through hoses and tubes to keep the airway open at all times. He was continuously ambu-bagged to deliver the required oxygen that his lungs needed.
Vincent Benjamin's parents were appraised that the child needed to undergo surgical intervention in order to correct his anatomical anomalies. However, given that he was premature, the surgery would be a high risk procedure for him. There were a lot of requirements that he needed to meet in able to forego with the surgery. He needed blood transfusions to get him ready to replace his blood losses during the proposed procedure. However, the available blood packs that his parents acquired were incompatible with his blood type. Also, the surgery was seldom performed and needed a specialized surgeon. His parents were undecided for weeks since they were not financially capable.
The baby was also put on last resort antibiotics which caused his parents a fortune in able to complete for 2 weeks as prophylaxis for infections that he would very much likely acquire. Aside from that, he constantly needed medical supplies and equipment for procedures to be done. His parents provided these as much as possible, exhausting all means and ways just to keep him alive.
However, he started bleeding in his last week of life. Replacing the blood loss was impossible because of the consistent blood incompatibilities. At this time, his parents were appraised by the doctors again and they have come to accept the reality that the child's life was already too compromised to be able to survive. They have gradually accepted and expected that they will lose Vincent Benjamin anytime soon.
He was endorsed to me as my patient (without supervision anymore) 2 nights ago. He had sternal retractions and nasal flaring, signs that the oxygen levels introduced to him didn't meet his body's oxygen requirements anymore. He continuously bled internally as evidenced by fresh blood I have observed upon suctioning his secretions. Vincent Benjamin slowly deteriorated until he took his final breath, moved all of his limbs and opened his eyes for the last time on October 3rd at around 2:30 in the morning. Since his parents signed a DNR (Do Not Resuscitate) form, refusing to give emergency drugs, chest compressions, or resuscitation in case of cardiac arrest, it was a peaceful death. His mother told him to just give up if he was already exhausted and so he did, after about 6 hours. We said goodbye and said a prayer for little Vincent Benjamin.
Why I wrote this little angel's story? He was the very first patient who died under my care and I know he is my angel from now on.
First times are memorable and unforgettable. This is why I am telling it now.
I suppose now we all just have to make do with our iPods and mp3 players for driving music.
