MVA by Rebecca Mateiro

 Most of us try and avoid working on our birthdays, right? Maybe not, since we barter for Christmas and Thanksgiving birthdays are just another day. I happened to be off my birthday and was watching TV with my two year old and his brother who was four at the time. My phone rings. Work. It's the radiology department. Weird. I'm a nurse but a close friend's voice speaks. 
Can you come in? The ER is crazy and they need help.
I can't. I have my kids. 
I'll watch them she says. They can hang out with me for awhile. Please.
What's going on?
A pediatric trauma. It's bad.
Five minutes
Juice boxes and crackers shoved into a backpack and a scrub top over my head. 
She's right. The ER is crazy. The ten beds are full and there is anticipation and urgency in the air. I find my charge nurse. She tells me to expedite discharges as fast as I can. As I go to get charts a nurse stops me. 
Please take care of this kid. I can't and you need to.
As an ICU nurse, I see trauma a lot. I haven't seen a peds trauma but I steel myself. My charge says I really wanted you to come and take care of the kid but didn't want to ask cause it's your birthday....and the patient is the same age as your son. 
It's OK. I'll do it. I walk in and a child of four is lying on a backboard. Normal saline bags taped bilaterally to his neck for c spine. Our small ER didn't have small c collars. He intubated and maxed on two pressors. He is bruised everywhere. Obvious broken arm and femur. OK Rebecca. Assess and stabilize I say to myself. I check the alarms, drips, tubing, ETT, IV sites, and ventilator. Finally, I look at him. He's fighting but doenst have much left I place my hand on his head to whisper it's 'OK baby, I got you,' but my hand trembles as I touch his head. He had so many skull fractures my hand slid his skull beneath my fingers. This is the point to which I think there is no hope for this child.
What other job do you get to see the end yet still push for a different outcome? Is there another occupation in which we use our sixth sense to see this is in vain yet still throw ourselves down to achieve one more month? One more minute? Can I say knowing this child was near the end made me work that much harder to give him the chance to hear his mother's voice? 
An urgency turned into controlled frenzy. The flight crew arrived and we worked for two hours more to make him stable for flight. He passed away 19 hours later. 
After six hours, I retrieve my children from the radiology department, they sat eating cheeseburgers and laughing. The trauma of this day so hidden. They remain innocent while I check and recheck their car seats.
I still think about that child on my birthday. How his mother is and his little brother, who survived the crash. I think about nursing and how my fellow comrades watched my kids so I could help. How seeing what we see makes birthdays so special but also, just another day.