When a Child Dies

How Pediatric Physicians and Nurses Cope

Robert S. McKelvey

  • $25.00s paperback (9780295986531) Add to Cart
  • hardcover not available
  • Published: 2006
  • Subject Listing: Health
  • Bibliographic information: 240 pp., 6 x 9 in.
  • Contents

How is it possible for practitioners of the healing arts to cope with the deaths of children and the devastating grief of their families? Physician Robert McKelvey looks squarely at this painful question and gets to the heart of it in When a Child Dies. Although the stories he tells are replete with heartbreak, he achieves a higher purpose by illuminating the successes and failures of medical training in helping doctors and nurses confront these deaths.

McKelvey interviews members of a pediatric hospital staff, specifically those working in intensive care and hematology-oncology units where children often die and where caretakers have a great deal of experience with terminal illness. His interview subjects discuss their family backgrounds and what led them into medicine; their education, training, and on-the-job experience that helps them deal with death; their emotional reactions to the death of a young person; and their styles of coping, both personally and professionally.

This is the first book to focus on the grieving process of physicians and nurses for their child patients. There is a wealth of information here that will be recognizable and comforting to those already in the medical profession and that will help in the training of those about to enter the profession. Physicians, nurses, and medical students, as well as sociologists, social workers, psychologists, psychiatrists, the clergy, and families, will find this book invaluable.
Robert S. McKelvey is professor of psychiatry at Oregon Health and Science University in Portland. He is the author of The Dust of Life: America's Children Abandoned in Vietnam and A Gift of Barbed Wire: America's Allies Abandoned in South Vietnam.

"This book by Dr. McKelvey is as important and valuable as any I've ever read. It is such a pleasure to read, no matter the melancholy moments in the stories told, and will appeal to a general audience as well as a medical one. I will with some passion urge this book on everyone I know. It's a major effort of mind, heart, and soul, conveyed to us lucky-and needy-colleagues with splendidly poignant and penetrating prose. I wish my one-time teacher (and hero), Dr. William Carlos Williams, were with us today. He'd clap his hands with gusto and say, 'Hurrah!'."
-Robert Coles, Harvard Medical School

"An original book, distinguished by the author's obvious depth and breadth of knowledge. His profound familiarity with his subject enables him to explain complexities of medical and nursing practice and intrapsychic processes of grieving with great simplicity. His cases and analyses resonate with truth. I would put a copy in every physician on-call room and nursing staff lounge in my pediatric hospital."
-Catherine Fiona McPherson, School of Nursing, University of Washington


Part I. Residents
1. "The patient dies and that's it, next patient!"
2. "They came into the hospital with a daughter and they left with a small blue box of her stuff."
3. "What prevents us from being 'midwives of death,' something that has always been the physician's role?"
4. "What could you say? It wasn't all right. Her beautiful only child was going to die."
5. "I can't remember a time that we got together and talked about our feelings. Men don't do that."

Part II. Attending Physicians
6. It's my job to get families through the worst time in their lives."
7. "Coping with death is a process; you find your own way."
8. "It's not about me, it's about the patient."
9. "People don't know how long the pain from the death of a child lasts. It takes years."
10. "I love caring for young families and six babies."
11. "I know I'm not God, but I always try to save them."

Part III. Nurses
12. "No one understands what we do and no one can empathize with what we're going through except us."
13. "I've seen way too many dead babies."
14. "Being faced daily with the fact that life is temporary and unpredictable seriously affects the way I live."
15. "There's nothing right about a dead baby."
16. "You can't open your heart to everyone and be grieving all the time."


Appendix A. Interview Questions
Appendix B. Survey of Prior Research