Tom Becka: Hello, welcome to another podcast at TomBecka.com, where everyone is exceptional and everyone has a story to tell.
This is one of those stories. I met Sarah Centineo a while back and didn’t know really much about her.
It’s one of those situations where you make a little bit of small talk, “Hi!” “How are you?” “What do you do for a living?” that sort of a thing.
What she does for a living, is that she is a nurse and she’s also a lawyer.
When I sat her down here, I didn’t know what to expect from this interview. I didn’t know what to expect.
I just figured that if you are a nurse and a lawyer, that’s got to be some interesting story to tell. There’s got to be something there. So I invited her in to sit down and talk and had a rather interesting conversation.
I started her off with a question that, well, I guess, is pretty much the obvious question. What possessed her to go after two very difficult careers?
Sarah Centineo: The nursing…I’ve been a nurse since I graduated from nursing school in 1997. I went into nursing because I’ve always liked medicine, and I really enjoyed science — not very good at math — but kind of dissecting things and figuring things out.
I started in nursing school, and I liked it, and I continued to do that. I graduated and started in home healthcare and then worked in a hospital shortly after there. I worked in the pediatric intensive care unit for the better part of the last 15 years.
When I was…would have been in ’08, when I started law school. I knew I couldn’t be a floor nurse for the rest of my life. It’s a very physically, emotionally, and mentally demanding job…
Tom: [indecipherable 0:01:57] especially for dealing with pediatrics.
Sarah: Right, and it’s pediatric intensive care. I loved the level of technical expertise that’s required, and I love learning new things. The thing about nursing and medicine is that you always — especially in a hospital setting — you’re constantly being challenged, and there’s new challenges all the time.
We see a whole population of kids that 20 years ago would never have lived. And now as they’re aging, as these kids are getting older, we see new challenges to their medicine. Kids who were 25-week premies 15 years ago are coming in as teenagers with problems that we have to deal with. So, that part of it’s so challenging, and I really enjoy a challenge.
I would say I’m not an overachiever. I’m just really competitive sometimes. [laughs]
Tom: You are a nurse, and you are an active nurse, working all this time. Let’s talk about that before we get to the law thing. I don’t know why you decided to go into law, I’ve often wondered. I admire people like you, especially pediatric nurses.
I don’t think I can do something like that. How do you handle the inevitable? Children die, things don’t work out or child may survive, but it’s never going to be completely right. How do you handle that?
Sarah: A career is like marriage. You have to figure out how to deal with the good and the bad. That’s my best analogy. In a marriage also I have to figure out how to disagree, and in nursing, especially in ICU work, you have to figure out how to handle that loss and how to not let it devastate you.
Tom: Do they teach that at the nursing school?
Sarah: No. Most professional schools, academic schools as opposed to straight schools, they don’t really teach you how to do your work. They give you the foundation of this wide…
Tom: Here’s how you put the needle in. Here’s how you deal with the oxygen, but not here’s how you deal with a baby dying?
Sarah: Yeah. They don’t give you any guidance, at least when I was in school, to the emotional and then metal aspect — how to talk to families. They talk about the process of grieving, but they don’t tell you how to do postmortem care for a dead child and how to make it as easy as you can for the family and how to not make it worse — which is your biggest fear in that bad of a situation.
Tom: On the other hand, though, there is going to be incredible rewards in seeing a child coming in and knowing that you help nurse that child back to life. And you get a healthy kid back to the parents. That’s going to be the amazing experience too.
Sarah: It is. Our problem in the ICU is that we don’t see them get better. We see them get not near-death and then they leave and go somewhere else to get to the rest of the way better.
Once they are off the ventilator, and their blood pressures are stable and they are not in critical condition, generally, they are transferred, because we have other kids that are coming in that are sicker. So, we don’t see them fully recover and walk out of the hospital.
Sometimes we get lucky enough and the families will come back to say goodbye to us. But for a lot of the families and it’s such a traumatic experience being in the ICU that they never want to see us again — even though they do appreciate what we do.
Tom: Yeah. But you bring back bad memories…
Tom: …like if you are in a supermarket and one of these parents sees you there. They may not able not to say, “Hey, how are you doing? The baby is doing great.” They may have gone and say, “Oh, yeah…” that’s a bad memories.
Sarah: I have parents come to me outside of the hospital and say, hello. A lot of times, you don’t recognize…I don’t know, I don’t recognize them.
Tom: You are dealing on a lot of people, yeah.
Sarah: Or, they don’t recognize me because it is out of contexts. They have their one or two or three children, but I have hundreds and hundreds of patients per year. So I don’t always recognize them unless they were there for a very long time.
Tom: If you’re dealing with the infant in ICU, how much of that is preventable? How many of these moms are either on drugs, how many of these moms have done no prenatal care, how much of these is preventable when you see these babies, these infants in the ICU?
Sarah: Well, I don’t work in the NICU, which all preterm babies or babies born with defects or birth trauma. I work in the Pediatric ICU.
I see the newborns…Usually one of the things we have are heart defects. We’re one of the few hospitals that deal with pediatric heart defects.
We also see the shaken babies, obviously, completely…
Tom: Oh, do you see that? How do you handle that?
Sarah: It really pisses me off. It is very, very difficult. It’s a very precarious position, because by the time when they come to us these babies are near death’s door.
The legal system moves much more slowly than the medical systems. It might move much more slowly than the medicine, [indecipherable 0:07:20] actually have physically happening.
Tom: Is that one of the reasons why you wanted to get into the law? Seeing kids who are abused like this?
Sarah: No, there is really…I have no real desire to do a family, family law or that kind of thing other than it’s a good knowledge base to have. It’s there’s too much messed-up — I am trying not to curse…
[crosstalk and laughter]
Sarah: It’s too fucked out for me, to be honest — the family dynamics and having to deal with that. If I have to defend one these abusers or if I have to deal any divorce or custody issues with allegations of abuse, and having to try to dig into that, and I just don’t know that it’s worth to me, it’s not worth that kind of the money that’s there for it, honestly, and all the grief that’s associated with that.
Tom: I had a friend years ago who is a lawyer and dealt with the divorce cases. She couldn’t take it anymore because it was affecting her marriage.
It’s because she would hear all of these bad cases and she would come home and just think that marriage sucks and no home and husband who is a great guy would be like, “Hi, honey, I’m home,” and she didn’t want to be around him because she was so negative with all the stuffs that the negative [indecipherable 0:08:34] , the negative vibe that comes with dealing that kind of law.
But I would think the similar negative vibe in dealing with these children in these situations…
Sarah: [indecipherable 0:08:46] the abuse stuff as hard, because I can’t say anything to the accused abuser. Usually a person hasn’t even been arrested. If the police actually catch this person actively abusing a child, shaking a baby, they walk in on it. Even if they have an eye with witness, they really can’t do anything because there is a process in place and the process is in place to protect. We’re innocent till proving guilty is one of our foundations of our law. So you can’t violate that.
As a nurse, as a care-giver, to me, I guess what I have to do is I have to just think I can’t assume anything. So, I would just do my best and I bite my tongue, and I watch them like a hawk and I do my best to give this poor little baby who is just a victim — the best care that I hospitably give her.
Tom: Now, you’re still practicing medicine [indecipherable 0:09:38] . You’re still a nurse, right?
Tom: OK. And do you also practice law?
Tom: That’s [indecipherable 0:09:45] . I mean both of the professions are so labor intensive, and at the same time, time intensive, but at the same time, seems so different.
Is there a common thread between being a nurse and being a lawyer?
Sarah: I don’t know if there’s necessarily a common thread. You don’t see very many nurse attorneys. I think that’s because nursing is a female dominated profession and being a lawyer or an attorney is definitely the white male dominated profession, especially when you get into litigation, which is what I do.
I can name maybe three other female lawyers that I know personally that do litigation, and that’s not very many. I could name you easily, off the top of my head, 15 men that do it, all over the age of 50, and who are successful in it. It’s not a very easy thing for a younger female attorney to get into. There are not very many people out there to support us.
Tom: When you got into the law end of it, did you…? Explain to me just what kind of law you’re doing. Do you deal primarily or exclusively in medical situations?
Sarah: I deal exclusively in Pediatric Medical Malpractice.
Tom: OK. Do you defend the doctors or the nurses, or do you prosecute, not prosecute, but work with the parents?
Sarah: I’m a plaintiff’s attorney in civil cases, so I get the cases that…A big part of my job as much as going…
There are bad doctors out there, and there are good doctors that make bad choices and that know better, and as a nurse…
Here’s probably the common thread, when we get back to that, is we’ve all seen in the hospital, or any physician, any nurse, any medical professional, patients who have been not treated properly, and the standard of care has not been followed.
So there’s basic, we don’t like to admit it in the medical profession, but standards of care. Things like, you give your immunizations, you get antibiotics for so many days. These are your standards of care.
We see these kids as medical professionals that come into the hospital, and the doctor is either ignored or overlooked or are reaching, are acting outside of their scope, and these kids suffer tremendously because of it.
Tom: How prevalent is that? Because with medical malpractice, it’s one of those deals where I think we’re sue-happy in this country. On the other hand, there are people that really are wronged and deserve some form of compensation.
Realistically, how big is the medical malpractice problem in America?
Sarah: Compared to the cost of medicine, the cost of medical malpractice claims and settlements, and I’m not exactly sure on the quote, but it’s like one to two percent of total medical costs are medical malpractice claims, and settlements, and verdicts. It’s a very small amount of the money that we pay as a nation towards healthcare.
What we see is a much larger amount of money that’s spent correcting preventable mistakes. You look at the numbers in a hospital, and you see medication errors. You always hear about the limb, the wrong limb that was taken off. Those are the stories that make it to the news.
Well, there’s a lot of smaller things that aren’t nearly so sensational that cost us hundreds of thousands and millions of dollars a year in medical expenses.
Tom: Like what? Leaving a sponge in somebody during surgery, or what?
Sarah: Absolutely. That’s a good example. I deal with a lot of birth trauma cases. For example, family practice physicians who continue to deliver babies, even high-risk babies, who don’t send them to a more advanced high-risk OB/GYN, where that’s a person that would be prepared to take care of the sick mother and the sick baby.
You have a sick mother, who’s giving birth to a sick baby. A family practice physician is doing the birth, and then you end up with two people nearly dying, requiring weeks if not months in ICU.
If that family practice physician had sent that person to a high-risk OB/GYN, you would cut that cost down easily in half and save a lot of pain and suffering and long-term damage.
Tom: If I am in charge of a hospital or if I am a doctor, and I know that the nurse I’m working with is a plaintiff’s attorney for malpractice, I may be hesitant to either hire you or work with you. Has that been a problem?
Sarah: Not at all.
Tom: Would you take a case that you were involved with?
Sarah: No. It’s a complete conflict of interest.
Tom: OK. So if when have you worked as a witness against the doctor, if you knew that there had been some malpractice?
Sarah: I have been called as a witness, and I have been named as a defendant in a medical malpractice suit before, working in the Pediatric ICU, because bad shit happens there. People are upset and want someone to blame, and sometimes bad stuff does just happen.
Would I hesitate to say I didn’t agree with what this person was doing? No, I wouldn’t hesitate. Would I advocate for somebody who I think made a good decision and it was just something you had to do and you had to decide right there? Absolutely, I would advocate for that physician. I would have no problem in that.
It’s not a plaintiff or a defendant. It’s really just what was the best thing for the child, and did you make the right decisions.
Tom: Do you think doctors or administrators treat you differently than they might treat other nurses, because of you law background?
Sarah: I think so, yes. More so, my treating physicians and my children’s treating physicians. [laughs] They’re more afraid of me than the physicians I work with. [laughs]
Tom: OK. Yeah. That makes sense, yeah. You’re there as the mom, making sure that…
Sarah: I personally get excellent healthcare.
Tom: When you walk into the office, “Hi doctor. Here’s my card.”
Sarah: Yeah. I’m like, “Do you know who I am?”
Tom: OK. So first of all, what was it like when you said you were a defendant in a malpractice case? What’s that like compared to being on the plaintiff’s side?
Sarah: Twice, I’ve been one party. The hospital I worked for was named as a defendant. They can single you out, particular care givers. In one of the cases, I was one of the kind of singled out people, and in the other case, I was just a witness.
The one where I actually had to go in and give a deposition, I was in my first year of law school when I did that. I didn’t go to law school until 2008. I was 35 years old when I started law school. I had been a nurse for quite some time.
It was very interesting, because most of the attorneys around here, 60 percent easy, went to Creighton, which is where I was going to law school. Old law professors never retire, they die, so we all had the same instructors. That’s literally how my deposition started.
Tom: You said that you realized as a nurse, you couldn’t do this all your life. You couldn’t be doing it all your life, so you were looking for something else.
Tom: Couldn’t you have taken your nursing experience and gotten a job in a doctor’s office and made it a lot easier? You know, nine to five, go work for a podiatrist, nine to five, weekends and holidays off. You could have done something like that and still made a decent living as a nurse without having to deal with all the other stress, right?
Tom: Are you like an adrenaline junkie? Do you get off on the stress and the pressure?
Sarah: No, I deal with it pretty well. I guess it depends on who you ask. I’m not a super type A personality. I’m always out there striving for more, and making things better.
I’m also not content always, usually to sit back.
As a clinic nurse, one of the things I love about nursing, what I do, is the technical aspect of it. Literally bringing someone back from the edge of death — it’s so gratifying to me that I had a part in that, and to be able to say that I can do that. I really enjoy that part of my nursing job. But, it is so emotionally and mentally taxing.
The other parts of nursing weren’t that much fun for me — the paper work and the giving shots, and the administering medication. Not nearly as sexy as the rest of it. It didn’t give me the adrenaline rush. I’ll be honest, and I didn’t have the experience doing that.
When I walk into the hospital I work at now, I’ve been there for 15 years. I’ve worked there longer then any other nurse in the unit. I have a certain amount of respect that comes my way because of that, and I’ve known most of the physicians since their first day.
Tom: There is a big turnover isn’t there?
Sarah: There’s a huge turnover.
Tom: Why is that?
Sarah: It’s the burnout. You look at our nurses, inpatient nurses, and especially ICU, Pediatric ICU nurses and you will be hard pressed to find anybody over the age of 32.
I think our average life span or average career of a Pediatric ICU nurse is about two and a half to three years.
Tom: I imagine what happened for most of these nurses. They’re young, they’re idealistic, they’re all energetic, and then they get into it and they realize that it’s a life and death situation to deal with this and they realize maybe it’s not always a happy ending. Therefore, that’s where they have the real problem with it, right?
Is this also been a problem with you, or maybe other nurses that you know? When they come home, I mean a lot of people bring their work home with them.
If you’ve had a bad day at work, is that an issue with the family, the husband, the kids and stuff? If you dealt with a dying baby, you can’t just come home and say, “Hey, honey, how you doing? What’s on TV tonight, right?” Or do you?
Sarah: No, you can’t. It’s really hard. That’s why I think you see the nurses so young, before they’ve started families of their own, and before they’ve gotten married and those things, because you can’t put all of your energy into your work. As you get older and your personal life gets more full, it’s much more difficult to expend that much energy at work.
My husband never asks me about work, and honestly he wants to hear about it at the hospital. My kids are old enough to ask, and they’ll listen, but they don’t really ask. They’ll just listen when I talk about it.
Tom: Now, a lot of wives would have a problem if the husband never asked about their job. Does that bother you sometimes? Do you want to talk and it’s just better not to?
Sarah: He’ll ask me, “Was it a rough day?” and I’m like, “Yes, it was.” He’ll listen if I want to talk about it. It’s not like he shuts me out.
Tom: He doesn’t pry?
Sarah: He is a teddy bear. It breaks his heart to hear it. He doesn’t know how I do it. I know he respects me for that.
Tom: He respects you and people like you for doing that sort of thing. I can’t imagine being in that sort of a situation and doing that.
Where do you see yourself? You said you can’t be doing this all your life. Where do you see yourself going with this? The law? Is that what you really want to be doing?
Sarah: Yes. I really enjoy it. I hope to continue to keep doing nursing in some part for as long as I can. Now, I only work now once a week, sometimes only once every other week.
Tom: As a nurse?
Sarah: As a nurse. It’s a lot easier because you can do anything for a day. It’s full time is when the burn out is the worse, because you’re there at least three days a week and they’re 12 hour shifts. It’s hard.
I’d like to keep nursing in some aspect. The people I work with, I think they like working with me.
Tom: I’d be remiss if I didn’t at least bring this up with Obama Care being in the news so much. How has this affected your job as a nurse, or nurses’ job in general? Has it been a positive, a negative, nothing? Does it have any effect on what you do?
Sarah: I don’t think it has any effect on what we do in the hospital as practitioners. Certainly, it has a big effect on the money we make because of the amount of money that comes out.
I don’t get insurance through the hospital, so I’m speaking out of turn for other Nurses. Even as hospital employees we get no particular discount on medical insurance…
Tom: I meant more on the lines of the requirements of that. Does that affect you at all as being a nurse? Not as far as you buying insurance, but as far as the job you do, things you either have to do, or can’t do because of Obama care?
Sarah: No. Not for the work that I do.
Tom: Good. Work me through this. You’re a lawyer now. The whole thing is, this fascinates me. I just suffered a tragic loss. I come to your office and say, “I want to sue the hospital, I want to sue the doctors, I want to sue the pharmacy companies, I want to sue everybody.” I’m mad. I’m outraged. I’m upset. I’m crying.
How do you handle this? What do you do? Where do we go from here?
Sarah: The first thing I would tell you. Usually, we have an intake person. She gives us the story. Then she comes to us. What we ask them to do is get all their medicals records and not to tell the institution, the physician that they are thinking about suing.
Most of the institutions, the hospitals, or the emergency rooms, even ambulance companies, they know when somebody is going to sue them.
You don’t call and ask for records usually unless there’s a problem. You usually know before that because you’ll get a lot of angry calls and there’s a lot of yelling, and there’s a lot of administration involved before usually before the person will call and attorney.
What we would do is ask for the family to get whatever medical records they can and not to inform the healthcare provider that they were looking into filling a lawsuit.
Tom: Even though they may suspect it, they don’t officially know that’s what they’re doing?
Sarah: Right. There is no response because we have control over our own medical records, you can ask for them, and you don’t have to give a reason.
The hospitals like to make you try to give them a reason, but you don’t have to.
Tom: They get the records, they come to you, then you look over them, and you realize if they have a case or not? Is that what you do?
Sarah: Pretty much. I usually spend a lot of time on the phone with them and we have conferences. If there’s a surviving child, I meet the child.
My co-counsel also does adult cases, and they have the same formula.
Then I go through the records meticulously, and this is where it’s a huge advantage to my medical background, because I know how hospitals are supposed to run. I know what nurses and physicians should be doing.
I have friends who I can ask, if I have questions. I’m able to go through and figure out if I suspect something has happened or if it was just really bad. Bad luck, bad circumstances and it was just going to happen anyways.
Tom: Out of 10 people that come to you that want to file a lawsuit or think they have a case, of those 10, how many really do?
Tom: Really? Malpractice is not as prevalent as we might think?
Sarah: The malpractice is there, the problem, I should clarify, that’s a case that we would pursue. There is malpractice out there that we won’t pursue, because it is so cost prohibitive for us to go after a claim that isn’t worth enough money to make it worth all of our while, because you can eat up in cost in a medical malpractice case very quickly. Your costs explode very quickly.
Tom: It might be, “Sorry that your child’s arm was set improperly, and they’re going to be walking around with a 90 degree angle in their elbow the rest of their life, but, it cost too much money to go after them and it’s not worth it.” That sort of thing?
Sarah: If it’s a permanent disability like that, that’s something we would definitely look at. But if you look at something, it’s usually like something that you’ve made a full recovery from.
So there’s no long term disability. Your damages were just the dollars, that’s where the real money is. In Nebraska and in Iowa, you can’t really recover for your medical expenses because you have to pay the insurance companies back.
So you have to have damages in the future, and pain and suffering.
Tom: You got to show that you lost earnings or whatever it may be before you can…?
Sarah: Interestingly enough, you have to pay your insurance back if you win your medical malpractice case, but you’ve spent your entire life paying your insurance to cover your healthcare, but then you have to pay them back. So, you pay them twice.
Tom: That argument could be made. At the same time, it’s also, if you’ve been reimbursed for the money they’ve put out. Otherwise, you’re double dipping, right?
The bills been paid, but you’re getting the money for the bill.
Sarah: But, you paid them, to pay the bill.
Tom: Was that one of Ben Nelson’s things when he was in charge of the insurance commissioner?
Sarah: It’s something that bothers me, the insurance companies, and we see this with Medicare and Medicaid too. It’s a bad system. I’m not saying they don’t deserve some of the money back, but being able to ask for all of it back where it’s very difficult for us as civilians outside of the billing process in institutions to figure out exactly how much stuff cost.
Tom: How many times will the insurance companies just go and say, “Look, we’ll write you a check for a few grand, leave us a lone”? In other words, not necessarily does the case have merit, but it’s just a thing where it’s just to much work to get it, we’ll throw it out there and see if they make an offer and take it.
Does that happen a lot?
Sarah: We have actually started doing that. It’s a fairly new process. At least that I’ve been around. It’s ADR, Alternative Dispute Resolution, where we contact the insurance carrier directly.
We will do that in cases, where the amounts in contingent, the damages are smaller or where the negligence are so obvious, it would be difficult for them to defend against.
It would cost them a lot more money to pay for a defense attorneys in the whole process. We would end up asking for less, because it will cost both sides less to pursue it.
Tom: What do you think people need to know about malpractice in the medical field? Not just in the pediatric, that you focus on, but as you mentioned, you have a partner that deals with adults.
What do people need to know about, the whole process and when they have a case, and when they don’t?
Sarah: As far generally as medical care is concerned, we really have to realize that doctors aren’t gods and they don’t know everything.
Tom: But, the doctors think they’re gods — a lot of doctors, not all.
Sarah: I love 90 percent of the physicians I work with and I respect 99 percent of them. I really have a lot of respect for them, but as a consumer, you have to look at it as your consumer of healthcare, you need to ask the important questions.
This is your life, this is your child’s life, and this is your father, your mother. You really need to not be afraid to ask questions and honestly Google your doctors. Ask other people about them, don’t blindly go with one person’s opinion, really ask around. It’s just the more information you gather the better off you’ll be.
Tom: I agree with you on that wholeheartedly. I do think it is as general as consumers of healthcare, we go over what the doctor tells us to, do whatever they tell us to do, you know “OK, I need this file, I need that fine,” and we don’t ask questions, we don’t do enough research. We wouldn’t buy a car this way but we’ll go and do whatever that the doctor says is, pay whatever the price is under healthcare.
Sarah: You see so many families like, “Well, my mum went to this doctor, my grandma went to this doctor” and I’m like, “That was 30 years ago, and you’re sending your child. How many pediatric patients does this physician have and are they current in pediatrics?”
If you have a family practice or just a DO, and they don’t have a specialty with geriatrics, intensive or internal medicine and they just generally treat the entire population, that’s huge!
From new-born babies to geriatrics, do you really think that they’re able to keep up with all of these standards of care for all those population?
Tom: That’s the old image. “The country doctor who took care of the families from cradle to grave,” that’s the old image, isn’t it?
Tom: It’s not the way to do it.
Sarah: In their absolute situations where you don’t have a choice, because they are the only physicians that are available to you, but you need to make sure that doctor is in communication. The way that we are now, we have so much access to information, your family doctor can call a pediatrician at the hospital at a pediatric facility, can contact an OB/GYN, can get referrals, can arrange things you can’t just settle for healthcare essentially.
Tom: You mentioned that you are primarily in a male dominated field.
Tom: Do you see yourself as some sort of a role model?
Sarah: No, I don’t ever see myself as a role model, except for my children I try to do best I can.
Sarah: I wouldn’t describe myself or say I was a role model, but I would say, probably it would be the way I act and carry myself. Other people see me as that, but I don’t hold myself up to a different standard than I hold everyone else up to. I hope that people can learn from me and I can learn from other people.
The same with the nurses I worked with. Most of the nurses I worked with, I could almost be their mother…
[laughter and crosstalk]
Tom: It’s [indecipherable 0:33:51] , right?
I work in a young industry too, and you’re working here with some 22-year old and you’re like “Oh man! I remember when I was that stupid too!”
Sarah: That’s what I always tell my roommate, “I was new once too. You go through it and it takes a while.”
But I learned a lot from them too. Certainly, they’ve been in nursing school more recently than I have. That’s the wonderful thing about medicine is that there’s always new things to learn.
Tom: What brings you the most happiness? Of the two fields, what brings you the most joy, the most satisfaction and why?
Sarah: I’ve been doing nursing for so much longer so there’s a lot more ups and downs in my nursing career — personally. Not professionally — I have been kind of an even keel.
I guess I would say I get more satisfaction generally from the legal aspect because I get to control it, I’m in charge. I don’t have a boss as an attorney. That’s a fantastic feeling! I love it that I don’t have to work nine to five. Sometimes I work 60 hours a week, sometimes I work 20, but I don’t have to answer to anybody else. I just have to make sure that my clients are happy that I’m doing my job as an attorney.
As a nurse, I get that immediate gratification of getting that IV in them the first time, that’s really cool, those are fun. I get the gratification of being able to remove breathing tubes from infants and this is one of the big ones, I got to let, I price…
A dozen times, I’ve been the first person that lets a mom hold their new-born baby because that baby’s been so sick. I can make that happen, so that’s really gratifying.
Tom: Yeah, there’s no way to describe what that must feel like. I mean I got chills just hearing you talk about it.
Sarah: We had this little boy who was in the hospital for a long time, he was in our hospital for eight months and I got to take him for the very first time — we have a terrace on the hospital — his mom and I and our respiratory therapist took him outside for the first time in his whole life.
Tom: How old?
Sarah: He was eight months old, he’d never been outside.
Tom: Never been outside. Had his mum been able to hold him during those eight months?
Sarah: Yeah. I was also the first person when he was…Right before he had his first surgery, I think he was about three weeks old, but he was only under 2 pounds. I was the first person that could get her to hold him.
Tom: That’s very cool. A lot of changes in medicine since you started, isn’t it?
Tom: It’s amazing what you can do now with these kids, isn’t it?
Sarah: Yes, absolutely. I think it’s a double-edged sword though. We were looking at being able to do so many more things that we can do. Then we were able to do, but we have, for example, these kids that have heart defects, that are born with these severe heart defects. Then when they’re 30 years old, they’re repaired, their residual repair, their scar tissue or there’s something we don’t have. Physicians and specialists are in place to take care of these adults that have these heart defects as children. It’s…
Tom: On the other hand, worst case scenario — that person lived to be 30 and they might not have lived before.
Sarah: Yes, Yes. Oh, we also have kids who were able to extend their lives for weeks, or months and they really have very little quality of life and that’s really is hard.
Tom: This is a tough question and maybe it is an unfair question. If it is, just say and it’s fair enough. What do you do with a kid like that? A kid that you know there’s just no way that this kid is going to get well. You’re just keeping them alive, waiting for them to die. Is that humane? I mean, we wouldn’t do that to a dog, we wouldn’t do that to a horse but we’d do it to people.
I think about this in my own life with my dad, the last years of his life, the last six months of his life. He wasn’t going to be living, he might be alive but he wasn’t going to be living. I always feel bad that we kept him around those last six months.
As a nurse, as somebody that deals with this on a day to day basis, is that fair to the kid or to the family? Do the parents appreciate every last day they can get?
Sarah: It’s a really difficult situation, I went through similar thing with my dad and I knew he wasn’t going to recover — my step-dad actually, who is like my real dad. I told my mother and she agreed with me though the rest of the family and my step dad were willing to look at that reality.
In the end, it was the end no matter what so it doesn’t really matter. From a practical standpoint, from a medical cold-hearted — it was expensive, it was a waste of time and resources. It was, but it was the only thing that we could do for him, because that’s what he wanted.
With the kids, I have a really hard time but it’s not my decision, so I just don’t really deal with that part of it and maybe that’s why I can continue to do it.
Tom: Thank you Sarah Centineo, now that was what I was talking about. I didn’t know where this conversation was going to go, I didn’t know what we were going to be talking about — we talked about a lot of different things and it was interesting. Talking about medical ethics, talk about dealing with sick children, talked about the legal ramifications of medicine. It was an everyday person with fascinating story to tell.
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