By Dr. Anthony Policastro

There are some parts of being a pediatrician that are harder than others. The hardest thing that I used to have to do was inform parents about their child dying.

Regardless of the circumstances it was never easy. There were times when I knew the family well and the illness was chronic like leukemia. In those situations, it was important to be there to support the family through their emotions.

When I went to Andrews Air Force Base, I was the pediatrician who took care of most of the cardiac patients. One weekend I was on a church retreat. One of my cardiac patients died that weekend. I could not be there for the parents. It was years before I could bring myself to go on another retreat.

There were other times when I knew the family well and the death was unexpected. That presented a challenge of a different nature. Those parents had not yet started the grieving process like those who were dealing with a chronic illness.

The hardest deaths to deal with were those when you did not know the family. The lack of a relationship made it difficult to know what to expect.

For nine of the 20 years in my Air Force career I was the Hospital Commanding Officer. That meant I lived on base. That also meant I was the closest pediatrician to the hospital. The result was that I often got called in for emergency resuscitations.

When I got to Seaford, I was the Medical Director at Nanticoke Hospital. That meant I was at the hospital all day. Therefore, I was still the closest pediatrician. I was the first one called.

The result was that I often was the one on the scene when a child was brought to the ER after an accident. I was often the one on the scene when a patient arrived in the ER after suffering a crib death. I was the first one called to the nursery when there was a sick newborn. All of these situations provided me with more than my fair share of giving bad news to parents.

When I was at Shaw Air Force Base in South Carolina, I got called to the ER for a resuscitation of a 10 year-old girl. She had been playing in a junkyard with her friends. An old dresser had fallen over and landed on her.

Unfortunately, the resuscitation was not successful. We were still working on the child and were getting ready to call the code unsuccessful when the mother arrived. I went out to tell her that it was not looking good. She yelled at me (anger is the second stage of grief) to go back and save her daughter. I later came back to tell her that we had to stop. It was devastating to her.

As it turned out the dresser had hit the girl in the chest. The autopsy showed three tears through the wall of her heart. Each time her heart pumped the blood flowed into the sac covering her heart and not to her arteries.

I really would have liked to have gone back in and save her daughter. Sometimes that is not possible. All we can do is give the bad news. Unfortunately, doing that is never easy.

COVID update- Numbers of new cases continue to decrease. Nationally, the total number of new cases this week was 762,000. That is down from 1,308,000 last week. That is the lowest it has been since the end of November.

Sussex County was down to 378 cases this week. That is the lowest it has been since early August when the Delta wave was just beginning.

Some people are waiting for COVID-19 to become like the flu. That may not ever occur. Mortality from the flu is lower than for COVID-19 infections. So it is not likely that the mortality numbers will ever be as low as the flu.

A small study looked at 253 people who were hospitalized in the early stages of the pandemic. It suggested that those patients who were Vitamin D deficient were more likely to have severe symptoms. There is no evidence that it prevents the illness. The small size of the study means the results could have been due to something else.

Another study in Brazil showed that Vitamin D in already hospitalized patients did not show any recovery benefits. Vitamin D deficiency at the start of the illness seems to be the deciding factor.

A word of caution is that Vitamin D is not water soluble. That means that excess doses are not excreted by the kidneys like other vitamins.

Too much Vitamin D can be harmful in and of itself. Thus there is no logic to taking high dose Vitamin D supplements to treat COVID-19 infection.