I think I will carry with me for ever the words of the surgeon who said 'Living is a gift', and paused, holding the camera's gaze from behind his mask; that gaze investing those words with deep and manifold meanings as he was about to operate on Blessings, a beautiful newborn baby with a complex cardiac anomaly. There were real risks and uncertainties about survival and long-term prognosis if this tiny baby made it through what would be the first of many operations.
For her parents this was their only hope.
Sadly Blessings didn't make it.
We witnessed the cardiac team at those usually closed meetings where peer group discussions and supervision allow for evidence-based, informed decisions to be made; harsh-light- of-day, life and death decisions made with consummate technical skill and expertise, but also with honesty and humility.
I was seriously impressed with the open acknowledgment and acceptance of the existence of the emotional attachment between the surgeons and their young patients and their families...
'Without it we have lost out humanity'
said Professor Martin Elliott.
The transparent recognition that this is an attachment that could so readily cloud good judgement and the trust between colleagues to be able to admit to that takes years to build, as do the recognised pathways in place for seeking other opinions from around the world in order to decide what is really in the best interests of the child and the family and their future quality of life.
The family who have clearly stated they will sell everything to seek surgery in the US in a final attempt to save their child's life if Great Ormond Street won't reconsider their decision not to operate...this self-induced poverty brought into the debate but not allowed to compromise any decision about whether to operate or to allow for a natural progression.
But who can forget little eight year old Brian, wide eyed behind his oxygen mask, sitting down and listening to consultant Philip Rees (who was there in my day I'm sure) as he gently explained the logistics of performing a heart transplant and answered Brian's questions so appropriately and kindly, and above all honestly...
'Will I be asleep?'
'Where will you get a heart from?'
'Why won't that person need their heart?'
'What will you do with my old heart?'
It was some of the most moving television I have watched in a very long time and how well I remember, even back in the 1970's and perhaps the trickier days of cardio-pulmonary bypass, being on night duty when the whole hospital would know that there was child undergoing lengthy open heart surgery. Often a child who had been an in-patient for months, and so one with whom many who had worked on the ward had formed an attachment and usually got to know the parents well too. By that unique form of hospital osmosis, the chat over meal breaks, we all knew their name and a particular sort of hush would descend... as of one all holding our breath during those hours of darkness through to dawn and collectively willing that the surgeons would be able to get the baby off the by-pass.
We'd go to dinner at midnight... baby still in theatre.
To tea at 3am...still trying to get the baby off the by-pass.
The phones would ring around the wards through the night...have you heard anything yet?
If you worked on Cohen ward (Infectious Diseases and Dermatology) on the ground floor you had in your line of vision the vase of white flowers that were ever-present in the front hall of the Southwood building of the old hospital. It was to this vase that the nurses laying out the body of any child who had died always went to collect a white flower to place between their crossed hands.
You did not want to see anyone coming down from Ward 1A (Cardiac) on the floor above you and going to that vase during that night.
Then going to breakfast after that interminably long night shift and hearing that the child was back on the ward and all of us heaving an enormous sigh of relief as we fell asleep exhausted over our cornflakes.
Sadly eight-year old Brian's new heart failed to work properly and he died two weeks after his surgery, and I suspect as those bleak words came up on the screen, the nation as of one was heartbroken and hopefully vowing to carry donor cards, but had also come away with a real understanding of the work and the dilemmas and difficult decisions that face the medical profession today.
There is always a price to pay for progress and the surgeons made the difficulties of that abundantly clear, but how amazed Charles Dickens, one of the hospital's founding fathers, would have been to know that his rather flowery sentiments in Our Mutual Friend continue to hold true, there may not always be 'cures' but it is still Children First and Always.
“[A] place where there are none but children; a place set up on purpose for sick children; where the good doctors and nurses pass their lives with children, talk to none but children, comfort and cure none but children.”
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