Continued Prayers, Wishes, & Hopes

I pulled up my last-year wishes for you and found myself nodding my agreement as I read, finding that the sentiment and spirit are as strong today as when I wrote them one year ago.

My continued prayers, wishes, and hopes for you and yours...have a Blessed and Happy Holidays.

Another holiday season is upon us. For all the unbridled joy and excitement that surrounds us, however, there is an uneasiness within my core that seems to seed itself every year. I don't think I am alone.

I have seen enough heartache through the year to know that joy and excitement can be very temporary. Can you even imagine wrapping presents only to return them after the holiday season because of an untimely death, never having the chance to give them? Over the holiday season, especially, heartache seems to magnify itself into a swirling tornado ready to touch down on so many lives. I've seen a lot of energy spent outrunning that tornado.

So, for all the happiness, I still can't help but be reminded of how hard these upcoming days will be for so many. My heart goes out to them. Especially the children.

How do I remember the important things in my life? And not just over the holidays, but every day? I know I have been blessed in my life. When I think of these blessings, none of them have to do with material things but rather things that spiritually feed my soul. Companionship, loyalty, kindness, and love. And more love. These make me a better person.

So, in the spirit of this holiday season, I share just a few of my prayers, my wishes, and my hopes with you.

I pray for my family, my friends, and those in the world that are in need. I pray that my son remains in remission for another five years, and another five years after that. I pray that my mother can look down on my family and smile. I pray she knows the power of her prayers, asking a forgiving God to show my son mercy and take her in His arms instead when they were both battling their malignancies. I pray that I can be gracious in adversity, always.

I wish for my family, my friends, and those in the world to know love, to embrace kindness, and to step outside the box and give more of themselves. I wish for endless hugs. I wish for good health. I wish for every child to know warmth in their heart and comfort in their soul. I wish for peace.

I hope that the ripples from compassion will disperse beyond our wildest imaginations. I hope that random acts of kindness multiply. I hope that thoughts of others will replace thoughts of ourselves. I hope that we all remember that we are in this together. I hope that your joy, your happiness, and your excitement is not temporary but rather infinite.

I pray you have a wonderful holiday season. I wish for all your expectations to be fulfilled. I hope the most important presents you will give this holiday season are gifts you can give each day through the year.

Happy Holidays...

As always, big thanks for reading... To my amazing readers...I truly hope this holiday season is blessed and happy for you and all the people in your lives.

The Wonder Of It All

Have you ever looked at a child only to find yourself staring in awe and amazement at the wonder of it all. I look at my three kids and am simply astounded that we did something so very right, my wife and I. The infinite smiles, the high-pitched laughter, the innocent and untampered views of life through their eyes, the heartfelt hugs--the list is endless as to the joys and delights they bring to our lives.

Even during my son's illness, when he spent several years on chemotherapy, I was awed at the resilience and beautiful spirit of not only him, but of my two young girls, his sisters, who also bravely walked the path of his illness with us. With heads held up, I might add. They wanted matching mediports so that their brother would not feel isolated with the "bumpy" on his chest. Pure and magical love.

As much as a setback as his illness was for our family, though, we survived that life trial and, in fact, emerged so much more stronger and appreciative of the offerings of this life. We were taught life-lessons that some people never learn. We reaped the benefits of compassion, both receiving and giving in ample, unselfish amounts. The small shit took a back seat to the more important "stuff" that life had to offer.

One of our amazing ER nurses, Kathy, the mother of a son with cystic fibrosis, said it best when Cole was first diagnosed. "Welcome to the 'Parents-Of-A-Sick-Child Club'," she whispered in my ear while hugging me. "It's a club that no parent would ever want to belong to," she continued, "but one that will change your life forever." No wiser words were said to me during that period of my life. Several times, I have reminded Kathy, who continues to struggle daily with her son's life, that the snapshot of her hug and her words will linger forever with me.

Mostly, I am thankful that my son's illness was a temporary, albeit two long years, and not a permanent fixture in our lives. We know we have been blessed. That our family is one of the lucky ones.

In the ER, when I meet the parents of an ill child, especially a prolonged, chronic illness, my utmost respect and compassion flows outward in tidal waves. I can only imagine the heartbreak and the struggles they have known in dealing with the fight for their child's life, trying to obtain just a wee bit of normalcy. Struggles that may never cease, that may continue to ebb away at the glimmers of hope and happiness that are too infrequent in their lives. Struggles that weigh down the shoulders and plummet the heart, time and time again.

A few years back, during the middle of a night shift, I walked into Room 22 to see CeCe, an unfortunate five-year old child born with microcephaly, a neurologic developmental disorder. There is a disturbance in the rapid growing of nerve cells, which results in a variety of symptoms, including striking neurological defects (such as mental retardation, severe intellectual and developmental delays, and seizures), a deformed, dwarfed body, and a shortened life span. Treatment for this illness is symptomatic and supportive. There is no cure.

As I walked into the room, diminutive CeCe was lying on her back in her treatment cot, her mother bent over her, stroking her braided and beaded hair while whispering into her ear. Her father stood along the other cot's side, stroking CeCe's hand. She was, despite her age, about the size of a two-year old toddler. She was nonverbal, and all four of her extremities were contracted and spastic. Her head, as expected, was quite small. It was a heartbreakingly, beautiful scene. CeCe was obviously loved.

CeCe had been brought in by her parents because her "trach" had fallen out in the middle of the night. She was in no respiratory distress, but it had been placed a year prior in the event she would develop any breathing difficulties. Her parents wanted to replace it themselves, but under a controlled environment ("just in case something goes wrong when we put it back in"). In essence, our medical team was just going to hang out and watch CeCe closely, on monitor and clinically, to make sure that everything went as planned.

After meeting the parents and saying a few words to CeCe, who had no response, I assured the parents that we were ready for them to replace the trach. "Who's going to do it?" I asked.

"I will," CeCe's father said, turning the new trach over in his hands, examining it closely.

"Are you sure you don't want me to do it or call in an ENT specialist?" I asked, feeling a little of his nervousness. "It's no problem for us, really," I assured him.

"No, but thank you. I would rather replace it in case it hurts my little girl."

Before starting, Mom crossed herself while Dad bent over to whisper his assurances to CeCe in her ear. "I don't mean to hurt you, baby," he said. CeCe had no response.

"I'm ready, honey," CeCe's mother said to her father, giving the go-ahead. Slowly, he bent over CeCe's throat, inserting the tip of the curved, plastic tubing of the trach into the small open hole of her anterior neck. It didn't go far, though. He was meeting some resistance.

"Are you okay?" I asked, watching CeCe closely through this. I had noticed CeCe squirming as he struggled with the resistance. "I think so," he replied, adding a little more strength to his attempts.

And then it happened. A small miracle of sorts. As Mom was bent over, whispering love to her daughter while Dad struggled to place the new trach, a sudden, brief smile passed over CeCe's face. I had seen it. I know I did.

With a little more effort, Dad finally was able to insert the trach to his liking. We secured its placement before obtaining a CXR to make sure it was placed appropriately and that we didn't collapse a lung or disrupt the trachea's integrity.

All turned out well. CeCe remained very stable, her vital signs normal and her clinical exam unchanged. The CXR confirmed a job well-done by Dad.

"I have to say," I told CeCe's parents before discharge, "that you have one lucky little girl. The way you both approach her, whispering in her ear and caressing her, is quite beautiful. Your love for her is very evident." I looked at the nurse, who nodded her agreement. "In fact," I added, looking at Mom, "I think I saw CeCe smile when you were talking to her."

"She did?" Mom asked, before continuing. "I live for those moments."

"Does she do it often?" I asked, wanting to hear more.

"Not often enough," Dad spoke, "maybe every few days at the most. We wish CeCe smiled more but, honestly, we'll take what we can get."

They were packing up, getting ready to leave, but I had one more question that I needed answered. "CeCe's hair," I asked both of them, "who braided it and put all those beads in?" Her hair was a sight to behold--numerous, small, loose braids that were delicately woven and tied with multi-colored beads at each end. Not an easy feat, I'm sure. "Oh, that," CeCe's mother said, blushing slightly, "I did that a few days back. I love doing it, actually. And CeCe seems to enjoy when I do it. In fact, her most recent smile was when I was tying those braids."

I pictured Mom at home, sitting behind CeCe, propping her up into her own lap, fluffy pillows surrounding them, and lovingly, with the utmost tenderness, combing out and braiding each little twine of hair, before beading its end.

Waiting for a glimpse of CeCe's brief smile. Living for it, actually.

Meeting CeCe and her parents reminded me of just how lucky a man I am.

If you are the parent of a chronically-ill child, I dedicate this post to you. Don't forget, for one minute even, that there are many of us out there who see you, who send you our prayers and good energy, and who recognize the love and effort you give to your child. Despite your struggles, at some point in your life journey, the reasons you were blessed with your child will become evident to you and will hopefully enrich your life and the lives of those around you. If they haven't already, that is.

The wonder of it all...

As always, big thanks for reading. I hope your weekend is a great one. Next post will be Monday, June 7. See you then...

No Love For A Father

The nurse hung up the phone, shaking her head.

"I can't believe the nerve of some people," she said, clearly aggravated by the phone call. The phone call, she explained, was from a gentleman inquiring about where he should check-in when he brings his father to our ER in a few weeks.

"In a few weeks?" the nurse asked, making sure she heard right. She did.

The gentleman explained that they were moving their father from the West Coast back to our side of the country, to be closer to family, after the father's third wife recently died. The caller had heard that it would be a much quicker process for their father to get into an assisted-living facility if he came through the ER.

"Honestly, sir, that is not a reasonable expectation, unless your father is ill and needing treatment. We are an Emergency Department," she said, enunciating Emergency, "not a place to bring your healthy father for placement."

Her words fell on deaf ears. Around 1 a.m., almost two weeks to the day of that phone call, another one of our nurses walked into the nurses' station, looking incredulous.

"Get this," she said, "this family in Room 22 brought their father directly from the airport to our Emergency Room to have him placed in an assisted-living facility. And," she continued, "they're pissed that they had to wait three hours to get called back from the waiting room."

It was a busy night but, eventually, I was able to make my way to their room. Their story was somewhat familiar with me, but I wanted to learn more.

"Hello, folks," I said, introducing myself to the patient and his family, consisting of two sons and a daughter. All local folks. All dressed in sophisticated clothes and very well-kept. I tried not to be judgmental as I continued. "What brings you to our emergency room tonight?"

"How many times do we need to repeat this?" asked the one son, the obvious spokesman. And obviously obnoxious. "We need you guys to get Dad a place to live here in town."

"At this hour?" I asked, looking at my watch. "It's 2 a.m., I don't think that's going to happen, sir."

"Well," said the son, "we've been waiting since 10 p.m. It's not our fault that it's now 2."

"Even at 10, sir," I said, staring at the spokesman, "I doubt we would have been able to accommodate you." Turning my attention to the patient, I continued. "Sir, are you hurting anywhere? Do you have any injuries or health problems that seem worse to you tonight? Anything that warrants you coming to our ER?"

The patient shook his head no. It was obvious that this was not his planning. I looked back to the son and cocked my eye. He just shrugged his shoulders. After obtaining more history from the patient, I performed a thorough physical. It was stone-cold normal. Clearly, this patient was mentally and physically stable and the family was simply seeking a short-cut to finding a place for their father to live. Heck, he could even live on his own if he wanted to.

"So, just to clarify this," I said, looking at his three grown children, "you picked your father up at the airport and drove him straight to our ER, at this hour, to be placed in a living facility? Am I correct?"

They all nodded. "But all three of you live locally," I continued, "why aren't one of you opening your home to your father until you can get him into a local facility?"

"We were told by several people, including my family doctor," the son spoke, "that this was the easiest way to have Dad placed." Shame on that family doctor, I thought. "And if you can't get him in a place tonight," the son continued, "then just admit Dad until you can get him in somewhere."

It's hard to get a rise out of me, but these people were doing a darn good job. I took a deep breath and tried to clean up my thoughts of these people.

"Well," I said, looking between the patient and his ungrateful children, "unfortunately, your information is wrong. I'll call our case management team down to discuss the available options for your family, but your father has no medical emergency and I won't admit him for the reasons you want. What your father does have, though," I said, "are three children who live locally that could easily provide for him until an assisted-living facility is available."

The family just looked at me. And I stared right back, alternating between them. I wasn't going to blink first.

"Well, then," the spokesman said, "can you call the case manager down to talk to us?"

I walked out of the room, disappointed in this family's dynamics. I'm sure there was more history between this father and his three kids than I was aware of, but still...to pick-up your father from the airport and bring him right to the local ER to dump him off? I would be ashamed of myself. Why even bother bringing him back here to live if this is how it was going to be?

Our case management team came down and, sure enough, were unable to place this patient directly into an assisted-living facility. The soonest they could arrange for his placement was in three days. Three days? People waited months for placement into a facility, and this patient would be there in three days. I guess it was a good shortcut for this family, after all.

"Three days?" said the son, "what kind of system is this? We can't wait that long. Do we have any other options?" No other options, said case management. No other options, said the nurse. No other options, I said.

The patient got dressed while his family grimaced and glared in our hallway. I seriously think they entertained the idea of leaving quickly without their father, but I kept my eye on them. I was ready to chase them down if they tried such a thing. I knew, just from observation, that they weren't above such a thought.

I have three kids of my own, and I shudder to think where a man could have gone wrong to get this kind of treatment from his own children. Did he spoil them? Did he wrong them so significantly that their refusal to take him in was justified? Or were his kids so caught up in their own lives that they had little time left for their father?

Regardless, the patient went to live with the spokesman son for three days. Three long days, per the son. I could only imagine, though, just how long those days would be for a father who felt no love from his family.

As always, thanks for reading. The next post will be Friday, February 5. Until then, if you haven't yet voted, go to Medgadget Medical Weblog Awards and vote for StorytellERdoc in both of his nominated categories. Your support and votes are appreciated! Big thanks!

Heroes Among Us--Gigi

The world just lost another angel. A hero. An ordinary person with extraordinary kindness and love.

Do you ever stop to think how often through your typical day you pass by an angel or hero and simply don't know? Busy, busy, busy. We have things to do, errands to run, and phone calls to make. We keep strangers at arm's length. And the cost of this hurriedness is simply that we fail to share and learn about one another. Every face we encounter holds a history, a story to be told, and sometimes those stories are remarkable and breathtaking. The unfortunate thing is that we will never know if we don't take the time.

Enter Gigi. Someone who always took the time.

Gigi was an EKG technician at our hospital. Almost nine years ago, as I have touched on previously, my son was diagnosed with a rare malignancy that required him to be on chemotherapy for a year. He failed to stay in remission and had to undergo a second complete year of chemotherapy to achieve remission again. Since then, he has been in remission for five years and is an extremely well-adjusted, bright, athletically-gifted boy who makes my chest swell with pride. Through his experiences, I have learned much about life, about love, about compassion, and especially about embracing the daily moments that hold the simplistic joys that many feel come only with big life-events.

What I was learning at that time in my life, however, Gigi already knew. She was frequently called down to our ER to do EKGs on patients and she could be overheard in conversation with them, asking them frank, sincere questions about their health, their lives. She seemed to really care and enjoy her interactions with each new face.

I didn't really know Gigi, however, until one day when she approached me soon after my son's initial diagnosis.

"How is your son doing?" Her voice had startled me and I looked up from my chart to find this middle-aged woman with a soft perm, intense eyes, and a big smile talking to me.

"Pardon me?" I asked, surprised at her bluntness. Most people either tiptoed around me or asked me directly about my son. I appreciated the latter approach and Gigi did too, obviously.

"Your son. I just found out about him and I'm praying for him and your family I just wanted you to know."

She was a stranger and yet, looking into her eyes, she was my immediate friend. I couldn't break my gaze with her. I knew that she got me, that she understood. She looked beyond my face and forced smile to see the hurt and anxiety that I was carrying.

"I'm Gigi," she said, holding out her hand. I took it and introduced myself. And she really did want to know about my son. How was he was doing? What medicine he was on? How was he adjusting to having a mediport? She genuinely cared and her thoughtful questions reflected that caring.

After a few minutes of conversation, she had to go do a stat EKG and I had to return to my patients. But before we parted, she asked "Can I have a hug?" A hug from Gigi, I learned that day, held more compassion that a hundred Hallmark cards. It was genuine and heartfelt--not just a quick expected pat on the back.

Through the years since, we learned much about one another's family, yet every time I saw Gigi, her first question to me would be about my son. "How's that boy doing?" His return to good health brought many authentic smiles to her face.

About a year ago, in the midst of a crazy shift, Gigi approached me with some worry on her face.

"Doc," she said, never once calling me anything else despite my urging to use my first name, "I'm really worried." She proceeded to explain that she had some abdominal bloating and intermittent pains for months but was afraid to approach her doctor. She felt it would be bad news and didn't want to face it or ruin her husband's recent retirement.

"Gigi," I said, "let's get you in a room. I want to do an exam and run some tests."

"Oh, no," she said in true Gigi fashion, "I'm off tomorrow and these patients need you today. Let me come in tomorrow to see you and I'll bring my husband along. I'll do whatever you say, but tomorrow, okay?"

Of course, Gigi. The next day, as I knew she would, she did come in with her husband. He was just as I pictured Gigi's husband to be--kind, considerate, supportive, and worried. Gigi and I had never taken our friendship beyond the hospital's walls and it was my pleasure to match her husband's face to her loving stories about him.

Unfortunately, Gigi's workup did reveal some serious findings. She had cancer. Cancer that had aggressively spread beyond its primary site.

With this news, I approached her room with a heavy heart. And knowing me as well as she did, she knew the minute I walked in the room that I held heart-breaking news.

"Just tell me, Doc. Don't sugarcoat anything."

I pulled up my chair, grasped her hand, and explained all her results very thoroughly. She cried, her husband cried, and I cried. It simply wasn't fair. Hardworking, decent, compassionate, loving--none of these traits had protected Gigi from something bad. It was her right, I felt, to only have good things occur in her life. I was really affected by her results and through the rest of my shift, I heavily relied on my Naphcon A eye-drops. It was now my turn to pray for her and her family. We admitted Gigi to continue her workup of identifying her type of cancer, its location, and its staging.

Remarkably, my son and Gigi had never met and, encouraged by my wife and I, all three of our kids made Gigi get-well posters. The next day, Cole and I hand-delivered the posters to her. She was in her hospital bed, her husband sitting in the corner, when Cole and I arrived. We knocked and walked through her room door. After looking up at us, Gigi immediately reached out her hands for Cole, who instinctively walked to her bed and sat down beside her. Gigi wrapped him in her arms and my lucky son received the same exact hug that I had received nine years earlier. If it was possible, his hug was even more magnificent than mine had been.

Through her battle, Gigi never once lost her faith or let her beautiful spirit waver. We shared hospital visits, phone calls, and cards, which never seemed to be enough to satisfy this sender's aching soul. She was, as you would expect and hope, surrounded by loving family and friends throughout her ordeal. She braved multiple rounds of chemotherapy and radiation and, despite her body's failings at times, pushed forward in attempts to beat off her disease. "I'm not doing this for me," she said, "I'm doing this for my family."

Sadly, though, Gigi passed away before the holiday season began.

Gigi was never defined by fame or fortune, but rather by compassion, kindness, and love. She embraced humanity wholeheartedly and clearly enjoyed touching the lives of others. If she hadn't taken the time with me nine years prior, reaching out to me in a dark moment of my life, I would have missed having an angel here on earth as my friend.

Gigi, I thank you for taking the time.

As always, thank you for reading. We all have a Gigi or two in our lives, hopefully more--if you want to share a little about your Gigi, feel free to in the comments. Next post will be Wednesday, January 13.