PICU

Last night, watching the Great Ormond Street documentary, I was reminded of the moment when I absolutely knew for sure that I had to be a doctor.

For those of you who haven't seen it, the documentary focuses on a different department in the hospital each week. So far there have been episodes set in oncology, surgery and cardiac transplantation. Last night's episode was in PICU - the paediatric intensive care unit. One of the things I really appreciate about this show is that it doesn't only show the happy endings. Some children, sadly, do not make it. Despite all the advances in medicine over the years, there are some things which simply cannot be fixed. Death is still very much a taboo in our society, and child death even more so. I feel it's really valuable to expose the fact that children can, and do, die. But I digress.

When I was 17, I spent some time over the summer holidays doing work experience in my local hospital. I was shadowing a paediatric anaesthetist and he arranged for me to spend time in all sorts of different areas. By that point, I was pretty sure I wanted to do medicine; I hadn't seriously considered much else since I'd started secondary school. Lots of areas impacted on me during that period I spent in the hospital. I saw some amazing things and some things that made me go home and cry. I heard stories which inspired me and stories which made me feel sick and disgusted at what humans are capable. I don't think I'll ever forget an awful lot of what I learnt then.

Of all of the moments which impacted on me, one in particular will never leave me. I was spending a day on PICU. There were two patients on the ward, a little girl of about 2 and a 3 year old boy. Obviously I can't give further details, but clearly they were very, very poorly. I sat and chatted with the consultant for a while about what was wrong with them, why they were there, what was being done for them. And then he told me that they were both very difficult patients to treat because it was hard to know what was in their best interests. Technology could keep them alive, but was it giving them any reasonable quality of life? It wasn't easy to know.

Later that morning, we spoke to the parents of one of the children. They also had another child; a delightful baby who was just beginning to say her first words. She'd learnt 3 words, alongside her babble. Mama, Dada, and the name of her sibling. She sat on my knee whilst the doctors spoke to her parents. They didn't know what else they could do. They didn't know whether it was fair to push medical treatment. They could keep the child alive. Did that mean they should? Well, that was the question which no one could really answer. After some discussion, it was decided that further aggressive treatment was not in this child's best interests. They would withdraw ventilatory support.

As the Mum and Dad said that they felt withdrawing was the best thing to do, the Mum began to cry. Their baby looked over to her and said, with just a hint of a question in her voice, the name of her sick sibling. I can't explain why, but right there, at that moment, I knew. I had to be a doctor.