The hardest part of Peds to me is when a child suffers an injury or gets a chronic disease that changes their lives forever. A permanent injury or chronic disease is a tragedy to anyone. The sad fact that it happens early in life makes it more tragic.
We have been caring for a previously functional, to most accounts, normal, 6-year old girl. Over the course of a few short weeks, she has transformed from a talkative 1st grader to a hemiplegic (one-sided paralysis), non-verbal body in a bed. Her eyes open and she grunts and cries when you approach her. She does not recognize her parents or grandparents.
What happened?
The truth: we don't know for sure. It has not been for lack of trying to find out. Last week, we went the final mile and did a brain biopsy -- understandably a last resort diagnostic. The neurosurgeon who performed the procedure reported dismally to the family that the consistency of the brain indicated breakdown and the sample he obtained may not have been sufficient.
After considering and rejecting multiple hypothesis, we now believe that this a form of post-influenza encephalitis -- a rare complication of the flu (which she had in early March).
It is our best guess that the changes that have occurred in this little girl are for the most part irreversible. I have no more to say in this case: the rest cannot be put in words.
Walking from room to room on a Pediatric floor in a hospital reminds me of that verse in the Bible: "Weep with those who weep and rejoice with those who rejoice."
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ADDENDUM
Our patient is now in rehab status. She speaks a few words and recognizes friends, family and nurses and doctors. Her left side is still pretty much unuseable. 'Progress' is being made...
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