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A Beating Heart

  • Christy Lucas
    Correspondence
    Address correspondence to Christy Lucas, MD, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh 4401 Penn AveAOB, Suite 5400, Pittsburgh, PA 15224.
    Affiliations
    Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pa
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Published:April 09, 2022DOI:https://doi.org/10.1016/j.acap.2022.04.003
      "Fourteen-year-old male with self-inflicted gunshot wound to the head” was a one-liner that gave me a reflexive shiver, raising the hairs on my arms in a warning of sorts. However, after being surrounded by death and dying in the PICU, shifting into survival mode, I did not pause to think about the trauma buried in that statement, unhesitatingly saying, "I will take him.” His name was Peter*, and he had come in overnight as a Level I trauma. As I read more about who he was from his family's firsthand accounts captured in the social work notes, I attempted to intellectualize what could not be intellectualized. I learned that Peter had a history of anxiety, and after a particularly difficult day at school, where he was threatened with another out-of-school suspension, felt that there was no other way out: trapped. All guns were locked in the home, aside from a single handgun in an office drawer. He had a mother, father, and sibling who loved him very much. His family was milliseconds too late and witnessed the gun shot, then stillness. They swiftly brought him to the emergency department, trying to save him, but the bullet's relentless path across his hemispheres proved to be unsurmountable. He herniated in the trauma bay, failing the standards of medical care used to prevent herniation. Surgery would be futile.
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