Putting the Children to Sleep, Part 2

I am approaching the end of my first month at the children's hospital. It has been a very difficult month. I have seen children with minor procedures, like ear tubes, circumcisions, and repair of broken bones, but I have also seen some really sick kids. Really, really sick kids. My first case on my first call at the children's hospital was a 14 year old girl who came in with abdominal pain, nausea, and vomiting. She had eaten with her aunt, who was having the same symptoms. The girl was admitted to the hospital Friday evening, given some IV hydration, and had some tests run. Later that night, she was having more and more difficulty breathing, so they intubated her, transferred her to the ICU and placed her on the ventilator. The following morning, I started on duty. I was called by the Surgery fellow, who started the conversation by saying, "She may die if we do surgery; she may die if we don't." He proceeded to tell me that she was recently diagnosed with lymphoma, but had not yet started treatment. The surgeons wanted to do exploratory surgery to see what was going on. I went to the ICU to evaluate her. Her mother was there, tearful and puffy-eyed. I introduced myself and explained my role in her surgery, that I was to keep her daughter comfortable during surgery so that she wouldn't feel anything or remember anything from the surgery. The mother left, as if unable to deal with the reality of what was about to happen. I reviewed her chart. "Jen" was an otherwise a healthy teenager, who took Tae Kwon Do. She had one brother. Her parents were married. Her father was an EMT. Two weeks prior to her admission to the hospital, she was perfectly healthy. She had no idea how sick she was.

Later, her father returned. According the nurses, he had been "the rock," the one who would ask the questions, answer the questions, the one who proceeded with reason. As we were preparing to take "Jen" to the operating room, her father broke down in tears. His sobs were heartbreaking. He went to Jen's side and talked to her comfortingly, "Daddy loves you, baby. You're going to be fine. It's going to stop hurting. Daddy loves you so much." One by one, various family members entered her ICU room giving her hugs and kisses and prayers. Her brother couldn't even speak; he just cried and held his head. We were about to leave for the operating room when her best friend walked in and sobbed, "Oh my God, Jen!" Although sedated and intubated, Jen looked at her friend, and tears started to roll down Jen's face, the first expression of emotion that we had seen throughout her whole ICU stay.

Once in the operating room, we assured her that we would take good care of her, then drifted her off to sleep with our potions. The surgery and anesthesia went just fine. She looked better. But the prognosis remained grim. The oncologist and surgeon had a long discussion about what to do. Her belly needed several months to heal, but her cancer needed to be treated sooner than that. Starting chemotherapy too soon might kill her, but not starting may kill her, as well. Apparently, they had a conference with the family, who decided to take Jen off of life support. When I heard the news that same day, my heart broke. I swallowed my tears and continued with the rest of my work day. I went home after call, and cried and cried and cried. Someone's little girl was gone.

There is little else that makes me appreciate my own children than seeing the struggles of other parents and other children. Many of the children I see were born with congenital anomalies and syndromes. Others are diagnosed with some form of cancer. Commonly, we see the victims of accidents. Some of their conditions are treatable, while others are not. These children and their parents are an amazingly strong group. Watching just a slice of their journey -the struggles, the triumphs, the attitudes with which they face both - makes me appreciate what is important in life. I thank God that my children were born healthy, and I continue to pray that they remain healthy and safe.

The other impressionable thing I see at the children's hospital are the neglected and abused children -the 2 year old whose mother's boyfriend fractured the kid's skull because he was crying too much. Or the 1 year old who has to get ear tubes for chronic ear infections because mom can't quit smoking. Or the crack baby who has to undergo repeated heart surgeries because he was born with holes in his heart. Sometimes I wonder if people should fill out applications before they are allowed to conceive children.

The hospital itself is an amazing facility. When I first walked in, it was like being at a toy store or a children's museum. I looked around in awe at how much fun it looked. It is colorful and festive. There are games and displays and toys. Everyone is so nice, too. I mean, people who decide to make it their career to work with children are usually pretty kind, fun people. I initially thought to myself, "My kids would enjoy playing with that train. Or they might like to take a ride in the wagons. And they would just Ooh and Ahh over the sparkly display in the lobby." Then I thought, "Lord, I pray that we never have to bring them here."