Baby Girl Doe was born 10 months ago and subsequently spent 6 weeks in the NICU due to respiratory distress. After her stint in the NICU, she developed a serious bacterial meningitis that her parents did not bring her in for until it was very nearly too late. She had a craniotomy to remove the infected tissue and now literally has half a brain. She has poor vision and a hyperreflexive tone in the arms and legs. She is and will forever be severely mentally retarded.
Her parents are mentally handicapped and have another child with a host of medical problems. They simply do not have the capacity to care for her. The parents have been told, legally, to stop having children. BG Doe is currently being cared for by a foster mom of sorts, a government employee who spends 16 hrs a day trying to address her complex needs.
She presented to the ED with a very poorly controlled airway. For long periods of time, every one of her breaths would be labored and gurgling. Her tiny body would strain and exert and struggle every second for air, all while her caregiver, an attending physician, two residents, and two students watched her. She would sometimes turn her unfocused gaze towards us, only for a second at a time. Gasp, gurgle, gasp, gurgle. This was her life. She had no reason to cry because this was all she knew. In a week she would have a Nissen procedure to help manage the reflux. There was nothing we could do about her brain damage or her home. And there was nothing we could do that particular day.
We continued to watch her. Gasp, gurgle, gasp, gurgle.