In June 2018, a nurse practitioner drove to the primary care clinic where she works. She was extremely tired that morning and had a full schedule of patients to see in clinic. She normally does not take her daughter to daycare, but decided she would take her daughter that day to help out her husband, who works nights as an ER tech. She worked her normal, very busy day and when she returned back to her car to go home, she saw her 21 month old daughter in the backseat – blue and unresponsive. Her daughter was taken to a nearby emergency room where resuscitation was unsuccessful. She later tells the police that she thought she had dropped her daughter off at daycare.
What is your initial reaction when you read a story like this? Are you angry? Sad? Do you ask how something like this could possibly happen? There were many public reactions to this story that were full of anger and outrage, but there were also reactions of support and understanding within the nurse practitioner’s workplace and within her community.
My initial reaction to this story was shock and a feeling of mixed emotions, as it often is for me when I hear or read stories like this one–complete disbelief that this had happened and sadness over the life lost. Anger and confusion about this happening to an innocent child. I know I only felt a small fraction of the horror this poor mother must have felt when she realized what had happened.
In doing some reading about this story and I came across a video about this tragedy by Dr. Zubin Damania, also known as “ZDogg” [1]. His video is extremely enlightening and offers a great perspective on how people, particularly those in the medical field and those with type-A personalities are susceptible to tragedies like this. He also offers concrete reasons discussing why something like this happened and how something like this could have been prevented.
Dr. Damania discusses how many people in the medical field are type-A personalities and many of us operate significantly within the prefrontal cortex of our brains–we are always planning and thinking ahead to the next thing that we have to do. The prefrontal cortex is responsible for executive functions such as carrying out goal-directed patterns of behavior, planning, information processing, memory, and inhibitory control of interference [2]. With all these processes occurring in the prefrontal cortex, including many more like regulating memory and language, it’s no wonder that this area of the brain can get overwhelmed. It is very possible that the inhibitory control of interference would be affected when the brain is overstimulated and tired,. How many times do we walk into a room of our house and forget why we went there in the first place? Or how often do we drive somewhere on autopilot and realize that we were completely focused on our own thoughts and not on driving? These things are extremely easy to do, especially when we have so much on our tired minds and and so many demands on our taxed bodies.
Also discussed by Dr. Damania are the changes that have been made to car seats and how their design relates to this tragedy. Car seats are required to be placed in the backseat and rear facing until age 2 years for child safety [3]. If the child is quiet or sleeping in the backseat and your bag is in the front seat with you, it would be pretty easy to forget to look in the back seat. What is going to remind you that your child is in the back seat, particularly when you never have your child in the car on your way to work? This is just one of the many aspects of vehicles that can be dangerous for kids. Because of this, there are organizations like Kids And Cars, which were founded to help raise awareness about child safety in cars.
This issue of safety of kids around cars is important. A recent study demonstrated that over a 25 year period, 3,115 children were left in unattended vehicles, with 729 of these cases resulting in death [4]. While this may seem like a relatively small number over a 25 year period, it is still 729 child deaths that could have been prevented and it does not include children who were not reported in this study. There are new products, such as mirrors that can be placed on headrests so that parents can see their child when looking in the rear view mirror, that help combat some of these issues and aid in preventing horrible accidents from happening to anyone.
There are many facets to this tragedy that medical professionals can learn from. Learning to think from another’s perspective and learning to empathize with others in their tragedies is an integral part of being an outstanding medical provider. In order for us to connect to our patients emotionally and not only focus on the medicine, we must learn to view situations from the perspectives of others. If we take a step back and think about how this happened to this nurse practitioner and we realize how easy it is to get wrapped up in our days and how much we have to do, it becomes easier to see how she could have forgotten her daughter. We may never understand how all the holes in the swiss cheese lined up that day, but we can begin to empathize with this mother and feel the pain she must have felt that day.
We must also learn to support each other as healthcare providers when bad things happen. Doctors, physician assistants, nurse practitioners, nurses, and all other healthcare workers must support each other when we face difficult losses, no matter what the loss is. Building a supportive environment within our healthcare teams can lead to happier coworkers and better communication. All of these things lead to better patient care, which is the goal of every healthcare provider. By having compassion and empathy for others, we become better medical providers and healthcare team members. While learning lessons through this tragedy doesn’t change the fact that it happened, it opens the door to begin to talk about difficult topics and change our perspectives when faced with challenges and hardships.
- Damania, Zubin. A Fatal Distraction: Can We Forgive When a Mom Forgets? http://zdoggmd.com/fatal-distraction/.
- Siddiqui SV, Chatterjee U, Kumar D, Siddiqui A, Goyal N. Neuropsychology of prefrontal cortex. Indian Journal of Psychiatry. 2008;50(3):202-208. doi:10.4103/0019-5545.43634.
- Child Passenger Safety: Get the Facts. CDC. https://www.cdc.gov/motorvehiclesafety/child_passenger_safety/cps-factsheet.html.
- Zonfrillo MR, Ramsay ML, Fennell JE, Andreasen A. Unintentional non-traffic injury and fatal events: Threats to children in and around vehicles. Traffic Injury Prevention. 2018;19(2):184-188.
Madalyn Nelson is part of the 2020 class at The University of Arizona College of Medicine – Phoenix. She is an Arizona native and graduated from Xavier University where she earned her bachelor’s degree in biology. Madalyn has a passion for traveling and global health. To contact Madalyn, please email her at madalyndnelson[at]email.arizona.edu.