Here's Part 2 of the article
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Somewhere between 10:15 and 10:30, a nurse
passing by
Conor's examining room heard noises. She discovered
that Conor
was breathing. It wasn't normal breathing, just a few
gasping
respirations, soft little sighs at varying intervals.
But it was breathing.
The emergency room physician Bruce Rowan came to
look. So did
a nursing supervisor. Conor was pinking up.
At 10:45 p.m., the phone rang again at Turner's
home.
Agonal Breathing
''Gasps or agonal respirations'' was how some in
the ER would
later describe Conor's breathing. Agonal breathing--a
type of
pre-death respiration, involving a primitive level of
brain function--is
often part of the dying process. It's what Gene
Turner says Conor
McInnerney was doing late on the night of Jan. 12.
It went on and on, though. It didn't stop.
Conor also had a heartbeat, albeit an abnormal
one. He had
nicely oxygenated blood coursing through his tissues
and adequate
blood pressure. Yet he was flaccid. He still had
fixed, dilated eyes.
Certain cardiac drugs can affect eyes in that
way. It's possible
they had in this case, but no one can say for sure.
Nor can anyone
say what the pulse and blood pressure meant. You can
have, as one
neonatologist put it, a pink baby whose ''brain is
still Swiss cheese.''
When does life end? What's futility? How to let
go? Such
questions just don't have clear answers.
''For all definitions, the child was dead when
it arrived at the
emergency room,'' is what Turner would later say of
Conor. By late
that evening, ''the infant had only some brain-stem
functions,
including near-death agonal breathing.''
That would have been around 11 p.m., when Turner
returned to
the ER for a second time. Death certainly can take
its time, one
nurse recalls Turner saying then.
This nurse, Vicki Gross, also recalls Turner
saying: The parents
are gone, they thought it was dead. I can't call them
back now. I
can't make them go through this again. How do you
tell them their
baby's breathing? It would be too much for them to
endure their
child dying twice.
Turner's assumption that Conor had no chance
didn't sit well
with Gross. ''It felt awful to us,'' she later told
her supervisor. ''Like
it was a done deal. I felt that he was hurrying this
along. . . .''
Turner left the room, came back. Conor's
hiccupy gasps
continued.
What is death? Apparently, Turner at this moment
wasn't sure.
As Gross recalls it, he said: ''Maybe we should bag
the guy. Maybe
we should intubate.''
Here is where Turner's actions become most
puzzling. If the
baby were dead or dying, then why try to save him,
why try to stick
in another breathing tube? Why not just walk away?
There was no official hospital charting of this
second round, just
informal pencil notes. But resuscitation efforts did
begin again. With
no success: Repeatedly Turner and Rowan failed to
re-insert the
tube, for Conor's anatomy was difficult. The nurses
grew troubled.
Things were getting ''really gross,'' one felt.
Turner asked for ice-cold cloths to wrap around
the infant. The
nurses also puzzled over this. It wasn't normal
procedure. Why are
we doing this? one of them asked. Turner cited a
study he recalled,
something about cooling in order to revive infants.
Dr. Rowan came back into the room. He too was
unfamiliar
with the cold-pack treatment, and concerned. Turner was
aggressively attempting a resuscitation effort, yet
he'd called the
code and declared the baby dead at 9:54. Rowan
couldn't fathom
how this baby was being managed.
Rowan wasn't a specialist though. He was an
emergency room
doctor, just 34. Turner was a pediatrician with
almost three
decades more experience.
Turner was more than that.
Ever since he and Norma settled here in 1970,
fresh from a tour
with the Peace Corps in Ecuador, they'd been leaving
their mark.
Stories abounded about the free treatment Turner
provided those in
need. For children with minor ailments, he left
holiday dinners to
open his clinic. For families in the remote western
reach of the
peninsula, he made biweekly pilgrimages in his orange
Volkswagen
Bug.
There were an equal number of stories about his
volunteer work.
He cut firewood for seniors and the indigent. He gave
land to
Habitat for Humanity. He donated truckloads of
home-grown
produce to food banks. He chaperoned middle-school youth
activities, though his own four children were all
grown. He hosted
an annual picnic at his home for disabled children.
Kids without opportunities should have a chance,
Turner
believed. ''It will do me very little good if I care
just for my child and
not yours,'' he explained to Paul Smithson, the
assistant pastor at his
Lutheran church.
''The guy just has integrity oozing out of every
pore,'' says
Smithson.
This is what Turner's friends and patients and
supporters know
of him. What they don't know--cannot know--is just
what Turner
thought and felt as he stared at a gasping Conor
McInnerney.
''I know I did the right thing under the
circumstances. . . . There
were mitigating circumstances,'' is all Turner was
able to offer
before his lawyers silenced him. The rest is informed
speculation.
That Turner didn't want the baby and the parents
to suffer more
pointless pain seems obvious to many. Others wonder
whether he
was physically tired, emotionally exhausted. There
are those who
think Turner made a mistake, misdiagnosed, then
panicked. A few
ask if Turner was simply in over his head.
Would a more experienced specialist have handled
things
differently? Why didn't Turner let nature take its
course? Was
perhaps the baby not going to die? Did Turner act
because he
thought the baby instead was going to live a wretched
life not worth
living?
Even Gene Turner's closest supporters struggle
for answers.
''Gene is a person, a human being,'' said
assistant pastor
Smithson. ''He's not above making mistakes. But what
would your
call be, after watching this baby for two hours, for
four hours? It
gets into gray areas. Bioethics, euthanasia, life,
death. Where do
you go in those nebulous four hours? Where do you go?
It's all
subjective. You have to rely on faith-based common
sense.''
''I'd like to think what occurred was
appropriate,'' said Olympic
Memorial Administrator Tom Stegbauer. ''It's real
hard for me to go
anywhere else with it. We're sitting here months
later. We're not
looking the parents in the face, telling them their
kid is dead, handing
them their baby, seeing their tears, escorting them
out of the ER. It's
not just a clinical matter; this is emotional. To
look at the mom and
say, you lost your baby. To go through all that, and
the baby starts
breathing again. What must have gone through Turner's
mind?''
At 11:40 p.m., a nurse entering the exam room
saw Turner with
his hand on top of the baby's head, patting it.
At 11:50, Turner was alone with the baby. Conor
still had a
heartbeat.
The ER physician Bruce Rowan by now felt uneasy
enough to
act. At midnight, he picked up a phone and called Dr.
Craig
Jackson, a neonatologist at Children's Hospital in
Seattle. This is an
essentially political call, Rowan began. Management
of an acutely ill
neonate is definitely not my field of expertise. But
I'm not
comfortable with the patient management being
performed in our
ER.
At about the same time Rowan was talking to
Jackson, nurse
Gross entered the examining room. She saw Turner
holding his
hand over Conor's mouth, she saw him holding Conor's
nose. ''I
can't stand it,'' she heard Turner say. ''I can't
have this go on
anymore.''
Gross sensed that Turner was feeling great
compassion for the
infant, that Turner felt death was inevitable. Yet
she still was
shocked and numb. So was a second nurse, Laurie
Boucher, who
also saw what Turner was doing.
A moment later, Rowan approached Turner. I'm
plainly not an
expert, Rowan told Turner. I didn't mean to be
condescending. But
I've called Dr. Jackson at Children's. Will you talk
to him?
Turner went to the phone; Jackson was no longer
on the line.
Turner walked back to Rowan. The ER physician thought
Turner
looked awfully sad and dejected. It's a difficult
situation, Rowan
recalled Turner saying. He also recalled Turner
saying: ''The
situation is over at this point.''
Rowan went to Conor's room. The baby now was
plainly
dead--cyanotic, ashen, pulseless.
Nurse Laurie Boucher, blinking back tears, told
Rowan what
she'd seen Turner do. Standing by Conor's body, the
nurse and
doctor briefly hugged.
Turner Never Obscured Actions
Gene Turner never tried to obscure what he had
done. On Jan.
15, two days after Conor's death, he called and asked
the baby's
parents to his office. Conor was a real fighter, he
told them. He
tried to hang in after you left. He showed signs of
life. We tried to
resuscitate him. I worked on him, but nothing helped
or changed.
Around midnight, I felt enough was enough. I pinched
his nose,
covered his mouth, let him go.
On the phone, Conor's grandmother, Diane
Anderson, heard
much the same from Turner. Like the parents, she
responded
graciously. She could tell he was hurting. This
doctor was being so
compassionate. He was also taking responsibility. She
sat down
and wrote Turner a thank-you note. She appreciated
his effort, she
told him; we can only do so much.
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TO BE CONTINUED