A Miracle Inside the Aurora Shooting

I was asking a friend if she ever wondered why did the Aurora shooting happen, or why God "let" it happen. Well, this may not be the complete answer, but it's definitely something: http://bstrait.wordpress.com/2012/07/22/a-miracle-inside-the-the-aurora-shooting-one-victims-story/

NICU - first time my patient passed away...

I guess it was kind of inevitable, that eventually one of my patients was going to pass away.  I actually didn't expect it.  Maybe I was naive, maybe I wasn't paying attention, or maybe I just had so much hope for the little kid.

The initial prognosis was already pretty bad.  It was a twin-twin transfusion syndrome, and my kid was the donor that became a recipient after laser therapy gone awry.  One twin was "donating" its blood into the other twin, and the laser therapy was supposed to stop the twin-twin transfusion from happening, but instead, the roles of the twins got switched.  My twin is supposed to have the better prognosis overall, but had brain bleeds and heart failure post-delivery- common complications.  The heart actually had gotten better, but the brain was slowly decaying.  The bowel perforation didn't help either.

Things were actually quite stable.  While there were no significant signs of impending doom, he had so much edema, it looked like he was a full term baby.  But then you see his tiny little button nose, and realize how puffy he really is.

Each day, we were hoping the little guy would keep on peeing, wouldn't increase his heart rate too much, and keep his oxygen saturation high.  It seemed like we were always playing this tag game with him: we would decrease his fluids, decrease his ventilator settings, and hope he tolerates it, but then the next day he would stop peeing or drop his saturations, and we would go back to square one.

Finally, one day, after being off for a day, I came back hoping things would still be stable. But he had significantly dropped his sats and urine output such that he had to be on a lot of supportive medications and got changed to an oscillator.  When I checked on him, he still moved his little puffy hands, maybe even grasping my fingers.  But before I knew it, there were already talks of redirecting his care.

I was hoping it wouldn't come to this.  I couldn't help wondering if maybe he would've been in better shape if I had checked an albumin level and infused him earlier.  Perhaps we should have checked his heart function earlier as well?  But ultimately, I think in the the back of my mind, I knew his brain function would have never recovered.  

It's puzzling how each person has a different way of dealing with the days before letting a loved one go.  Some prefer spending each waking second with that person and treasuring every last bit of love, while others prefer to distance themselves early while they can, before more emotional attachment could form.  My little guy's family chose the latter.

But no worries, the little guy was loved plenty the few minutes before he went to heaven.  He was dressed in normal cloths as best as the nurses could manage and surrounded by nurses and other healthcare workers holding him, watching him, and capturing him forever in the form of photographs and little footprints.  He even had his little toy puppy watching over him.  And after all the ceremonial acts were done, he was given plenty of sedation, and taken off the ventilator.  As the minutes ticked away, all we could do was watch him slowly turn bluer and bluer, while occasionally taking little gasps of air, until his heart stopped beating.  I didn't know why I didn't feel any sorrow at that moment, but when I held his little body and touched his button nose, emotions rushed in.  He had hardly lived on this earth, and he was gone. Just like that. But for me, it was like he was still my little baby whom I visited each morning to listen to his quick heart beats, coarse breath sounds, and just possibly, a gurgle in his stomach.  

Sal Khan's Commencement Address

What a wonderful and funny speech!  Here are some highlights:

• Of our many close friends from MIT, 90 percent are married to each other.
  
  Now, I think this many friendships and marriages coming out of one place, as romantic as the Infinite Corridor may be, begs some introspection.
  
  In fact, so extreme is the coupling that I have observed here that I have sometimes suspected that this whole place is just a front for a DARPA-funded human breeding project.
  
  However, there are simpler explanations for all of this MIT-MIT love. The most likely of which is that the admissions office here has a somewhat unhealthy habit of only accepting incredibly attractive people. 
• I always tell people that MIT is the closest thing to being Hogwarts — Harry Potter’s wizarding school — in real life.
  
  The science and innovation that occurs here looks no different than pure magic to most of the world. The faculty here are the real-world McGonagalls — that’s you President Hockfield — and Dumbledores. There are secret tunnels and passages with strange wonders and creatures around every corner — some of whom may just finish their thesis this decade.
  
  Also like Hogwarts, MIT brings young people from around the country and world who are a little bit off-the-charts in their potential for this “magic.” Some come from environments and communities that celebrated their gifts. Others had to actively hide their abilities and passions for fear of being ostracized and ridiculed. Students come to MIT from every religion, every ethnicity. Some from educated, affluent families, others from ones that live at or near poverty. But they — you, we — shared a common passion. Something that made us feel a little different. We sensed that MIT might be a place where there were others like us. Where we could challenge ourselves and develop our craft. 
• You will actively seek other MIT people out. When others talk about an intellectually challenging experience they had or complain about how hard they had to work, you will glance at the other MIT grad in the room and share a quick smirk.
  
  And if you are the preferred gender for each other, then you also might just realize that they have a certain twinkle in the eye. A certain beauty to the tilt of their head when they are deep in thought. Their competence and expertise makes you wonder what type of civilization you could create together. In short, you discover that you find them irresistibly attractive.
• Start every morning with a smile — even a forced one — it will make you happier. Replace the words “I have to” with “I get to” in your vocabulary. Smile with your mouth, your eyes, your ears, your face, your body at every living thing you see. Be a source of energy and optimism. Surround yourself with people that make you better. Realize or even rationalize that the grass is truly greener on your side of the fence. Just the belief that it is becomes a self-fulfilling prophecy.
• If you find yourself arguing with someone whom you respect and love, try to surrender your own ego to the shared identity you have with that person. In the heat of an argument, do the opposite of what your pride tells you to do. If you have the self-control, stop talking and give your opponent a random, super-mega hug.
  
  Make people feel that you care about them. And here’s, a well, a little secret, the best way to do this is to actually care about them.
  
  Make people feel that you are listening to them. Another little secret, the best way to do this is to actually listen.
• When you feel overwhelmed, walk alone through the woods and forget your name, your title, your education and view yourself for what you really are — another mammal wondering why it is here but appreciating the fact that your civilization has not as yet been evaporated by a supernova. 
• One of my roommates when I was two years out of college, who had formerly been a bit of a track star at MIT, and I had finished watching Chariots of Fire one night at 2 a.m. I told him that it made me feel like running. He simply told me “Don’t waste inspiration.” I reminded him that it is 2 a.m. He said “so what; don’t waste inspiration.” I looked at him for a few seconds and realized that he was dead serious. I jumped off the couch, threw on my running shoes and took to the streets.
• Imagine yourself in 50 years. You’re in your early 70s, near the end of your career. You’re sitting on your couch, having just watched the State of the Union holographic address by President Kardashian.
  
  You begin to ponder your life. The career successes, how you’ve been able to provide for your family. You’ll think of all the great moments with your family and friends. But then you start to think about all of the things you wished you had done just a little differently, your regrets. I can guess at what they might be.
  
  Sitting in 2062, you wish that you had spent more time with your children. That you had told your spouse how much you loved them more frequently. That you could have even one more chance to hug your parents and tell them how much you appreciate them before they passed. That you could have smiled more, laughed more, danced more and created more. That you better used the gifts you were given to empower others and make the world better.
  
  Just as you’re thinking this, a genie appears from nowhere and says, “I have been eavesdropping on your regrets. They are valid ones. I can tell you are a good person so I am willing to give you a second chance if you really want one.” You say “Sure” and the genie snaps his fingers.
  
  All of a sudden you find yourself right where you are sitting today. It is June 8, 2012, at Killian Court. You are in your shockingly fit and pain-free 20-something body and begin to realize that it has really happened. You really do have the chance to do it over again. To have the same career successes and deep relationships. But, now you can optimize. You can laugh more, dance more and love more. Your parents are here again so it is your chance to love them like you wished you had done the first time. You can be the source of positivity that you wished you had been the first time around.

Rest of Sal Khan's Commencement Address