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When Teamwork Takes a Noble Turn

It was early Friday night and I was already struggling with a number of Computed Tomography scans (CTs) with critical findings. The phone rang, and there was a trauma activation. 

The story: 5 year-old pedestrian struck by car, flung 15 metres. 

On assessment: GCS 3, pupils fixed and dilated, tachycardia, large cephalohaematoma, FAST negative, a couple of long bone fractures.

My assessment: Not good at all. 

The A&E CT room was packed to the brim. Teams from emergency medicine, general surgery, orthopaedics and neurosurgery were already on scene. I slipped in, signed the approval for IV contrast administration and begun reading the CT brain and cervical spine. 

The patient had a massive subarachnoid haemorrhage with diffuse cerebral edema and impending tonsillar herniation, plus extensive base-of-skull fractures. These were all images consistent with a patient nearing death. 

Everyone jumped into action and with some coordination, every person in the team slipped into their role quite seamlessly. Someone was calling for transfer of the patient to a paediatric hospital, another was getting mannitol to reduce the patient's intracranial pressure and others were checking blood test results. The registrars and consultants were discussing the best way forward to treat this patient. Here was a child fighting for her life and it was clear that everyone was fighting to save her as well.

Me? I worked quickly on delivering the provisional report of the patient's injuries.

Unfortunately, the patient's extensive injuries caused her to succumb the following morning. While there was no happy ending, it was a true privilege to be part of the multi-disciplinary team that night. There was no fault-finding, no turf war, no “taichi-ing”. I was moved by the unity in that CT Room as we worked towards the common goal: saving our patient.

As a Radiology Resident, it is a standing joke that we are merely report-churning machines behind our computers in a dark room. While we may not be the ones physically resuscitating the patient, we certainly play a role in timely diagnosis and prognostication. Every one of us has a part to play in the patient's treatment and no one is any more valuable or dispensable than the other. 

I will always remember this little girl and how she reminded me of why we do what we do, and how we should do it together. Rest in peace, little one. 

*Patient details were changed to maintain patient confidentiality.