Ink

I realize there is still blue ink underneath my fingernails. It reminds me of him. We got the fire department call announcing a four-month-old in full arrest four minutes away by ground. My hands shook as I prepared the IV set up and monitor leads. Within minutes that seemed like seconds the large frame of the firefighter came into view with the tiny, stiff child in his big hands. The firefighters watched as we made futile attempts at obtaining intravenous and intraosseous access. Intubation was impossible because rigor was already setting in. I took over chest compressions for several minutes. His rectal temp was 95 degrees. Blood was already pooling on the child's back and extremities when we called it. Time of death 1428.
The blur of people soon clears and eerie silence remains. Soon I am alone with him. I fold his clothes for the coroner. I swaddle him, pray over him, bless him. I wipe his nose which is leaking. I promise him I will stay with him until his family arrives.
The social worker and charge nurse were under the impression that the father was at home when the child arrested so they walked him directly to the room where we placed his dead child. I was hesitant as I assumed he was at work when the death occurred. We later found out he had been at work but arrived first at the hospital because his wife misunderstood the firefighters and believed they had told her to stay home. Instead she improvised and called her husband and told him to go to the hospital. This was after she found her child was blue and not breathing and could not call 911 so she had to run to the Korean speaking neighbor's home to call for help.
I suppose nothing could have prepared him for walking into that room. He was quiet and then slowly, softly at first, the moan of agony erupted from his chest. He laid his hand on his child's forehead and wept. I sat with them and cried.
I asked him if there were people he could call. He quickly left the room and called his co-worker to retrieve his wife from their home. Within a half hour the mom arrived. I will not forget the sound of her cry when she saw her child. I scooped him up and placed him in her arms. She whispered to him in Korean, rocking him, touching him. Her warm tears fell on his cool, pale cheeks.

I got out the Korean remembrance packet and asked if I could place the ink of his hands and feet. I explained to the mom that underneath the blankets she would see all the monitor stickers on the child and the large bore intraosseous needle sticking out of his leg. She nodded numbly. The hands were too rigored to do handprints so we did little footprints. The ink had to be meticulously wiped off because coroner's cases technically can have nothing touched or changed from the time of death.
The police arrived and brought an air of businesslike methodology to the already unceremonious death. They wrote down all our names, titles and phone numbers and checked the body for obvious trauma with the parents present. The family was informed that it was a courtesy to allow them to hold the child and to brace themselves for the coroner’s office who would soon be coming to retrieve the body.
The death investigator, a registered nurse herself, arrived and the policeman nudged me. "Okay, can you take the body away now because the death investigator is going to need it and I don't want to have to make a scene." Elected by default I took a deep breath and walked into the room. I told the family friend it was time. The mom looked at me in horror. How could I take her child from her? I hated myself as I attempted to take the child. She wouldn't let go. I tried again and with a sob she released him into my arms. She fell onto me clutching the child, whispering, crying. One last choked goodbye and her face became blank as she limped out of the room.
I was amazed at the tone the room took as the family exited. The shrine became a classroom as the death investigator explained her thorough and quick exam. She took pictures of him, jotted down notes and determined the most likely cause of death to be accidental 'soft' smothering. This concurred with the mother's story that she had napped with the child, gotten up, saw the baby sleeping on his tummy, gone to do the dishes and upon return found him dead.

The death investigator then flipped through the digital pictures on her camera and showed me the infant she investigated yesterday whose death was most likely a negligent smothering in a shared bed. I saw pictures of the dead child, pictures of the mother, the house, the trash cans filled with beer cans, the dirty bathtub (in case it is determined a drowning), pictures of the mother placing a baby doll on the bed to demonstrate how she had laid the baby to sleep. The death investigator then explained to me and the audience of police officers how we should wrap the body and added that she would later take the wrapped body in a carseat back to the coroner's office.
Officers swarmed the ER and the family was interviewed by endless rounds of social workers, police officers, the coroner, detectives. The crime scene investigator photographer showed up and took more photos while the family remained in the conference room with the final wave of child abuse investigators. When the family left the ER they were to be escorted back to their home where more pictures and interviews would be done and their home treated as a crime scene.
The ink can stay underneath my fingernails. I don't want to forget this one. At least not tonight.