Showing posts with label child. Show all posts
Showing posts with label child. Show all posts

Friday, September 10, 2010

The Reverse Peeper

It is 7:30 a.m. A weekday. Imagine that you walk up the two-lane driveway that leads to the brown-sided, two-story home, accented by shaker shingles and maroon shutters. You gingerly approach the burgundy front door, the morning sun warmly glowing against the house's reflective, cross-hatched windows as it bathes comfort to your posterior neck. You deeply inhale the passing autumn breeze, saturated with the smells of change. Slowly, you open the front door, turning the gold-plated handle down while pushing inward. You step forward, off the brick-lined stairs, into a foyer entrance.

You step onto warm, beige tiles as you gently close the door behind you. Facing you, a winding staircase embraces a wall completely covered in a variety of frames, their contained pictures telling a story of past and present family, from grinning babies with sprouting hair to formally-dressed young couples in love during the depression era. You glance to your left, noticing the wide, oak-framed doorway that leads into the formal room. A mahogany piano with glittering white keys sits in the corner, sheet music scattered across its front.

To your right, you see a glass-paned door invitingly open, leading into a home office. You casually peer in, noticing the filled mahogany bookcase, the L-shaped desk with a pile of paperwork off to one side, and the cozy, hunter green leather chair, draped by a matching green afghan and ottoman, in the far corner. You notice shelves of collectibles, more frames of family, and hung diplomas and artwork on the coffee-colored walls. The room looks comfortable and lived-in, a room you can accomplish paper-work in.

Finally, you notice the two oversized, side-by-side windows that dominate one entire wall. They face the front yard, watchful of the path from you which you just arrived.

And watchful of the path that leads away.

In front of those windows, on most mornings, stands a father watching his children walk away from their protective, comfortable home to their bus stop. He stands there in his pajama bottoms and a white cotton t-shirt, holding a steaming cup of coffee. His forehead and nose press against the pane, hoping his children will turn around to give him one last wave, one last acknowledgement, before they will soon round the bend of their cul-de-sac and no longer be in view.

He watches his oldest child, as tall as her mother, walk beside his middle child, his only son. They walk alongside one another, occasionally stopping to shift the heavy backpacks they carry. They nudge each other frequently, bumping into one another with the familiarity that only family knows. Their faces turn frequently to one another, and the father can see clearly the smiles and laughter privately shared between his two children. It makes him proud. Soon after, though, they separate, she going with a friend who met up with her and he chasing after two friends waiting for him further down the road.

They round the bend and disappear from sight. They are growing up too fast, the father thinks, wishing to himself that he could rewind time and slow down the hectic pace of life. He exhales, turning to face his quiet office, wondering if today will be the day he finally attacks the pile of paperwork waiting for him. He sits in his office chair and pulls up to the desktop computer. He is reflective, sitting there thinking about the stillness of the house. It seems too quiet. Perhaps, he thinks, he will write about this moment.

Within five minutes, thankfully, the stillness of the house is interrupted. A young, sweet, girlish voice, the voice of his youngest child, greets him. "Good morning, Daddy." She walks down the winding stairs with her bed's comforter wrapped tightly around her. He pauses at his computer, returns her greeting with a hug, and lets her begin her day. Her mother waits for her in the kitchen.

By 8:30, she too is ready for the school day. She stands at the front door yelling her last goodbyes, hooking the straps of her backpack around her strong shoulders. As she pulls the door shut, the house's canyon of stillness that just an hour earlier had haunted the father reemerges.

He resumes his position at the office windows. He watches his little girl traipse across the front lawn, her foot steps temporarily etched in the morning dew. She marches directly across the street, her blond ponytail swaying with her enthusiastic steps, where her bus stop awaits the queen's arrival. There are nine kids, ranging in age from kindergarten to fourth grade, and four hovering parents each morning. The father sadly shakes his head, thinking back to the days when he stood in line waiting with this daughter, a proud hoverer himself. Since those days, however, he and his wife had been dismissed from the job. "I'm too old to have you walk me out anymore," their independent daughter had explained.

The parents greet his daughter and look to the window, waving to the father, knowing he stands there on his days off. He returns their wave. The youngest of the children rush his daughter, their small arms quickly jumbled around her waist. She drops her book bag and kneels down onto one knee to return the hugs. Smiles and giggles and endless circles of running fill the next five minutes, until the screeching bus rounds the corner and stops to pick them up.

Through the bus windows, the father sees shades of his daughter's body as she walks the bus's main aisle until the last seat. She plops down her book bag before sitting herself down. On some days, she remembers to wave to her parents from her window as the bus pulls away, but this was not to be one of those days. The father waves eagerly anyway.

As the bus rounds the bend and leaves his sight, the father, once again, turns to face his quiet office and the stillness of the house. He had grown accustomed to a summer of chatter, of laughter, of arguing, and of simple daily moments--moments now stolen back from the eight-hour school day.

The father sits at his computer and stares at the blank screen. He misses his kids already. He is, however, not that naive to think that his pain is isolated. Parents everyday walk this path he is on. How they cope, however, may not be the same way he does.

He writes.

And so he pulls himself up to his desktop and begins. It is 7:30 a.m. A weekday...

Big thanks, as always, for reading. I hope you have a great weekend. This piece was an interesting one to write. I hope you enjoyed the peek in and "the father's" unique perspective.
See you next week!

Friday, June 4, 2010

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...

Wednesday, February 17, 2010

A Mother's Cry

It happened again last week. Among the hustle and bustle of a crazy shift. A pre-hospital radio call from an ambulance team that nobody ever wants to receive.

"We're bringing you a child in cardiac arrest."

Noooooooo. Word traveled quickly through our staff, and the mood immediately got very somber as everyone prepared the resuscitation room for this child. We could only pray that the child being brought to us would respond to our life-saving measures.

Nurses ran to get the intubation and IV trays, pharmacists ran to get the resuscitation cart with all the emergent medications, techs ran to get the EKG and ultrasound machines, and respiratory therapists ran to get a ventilator. Two of us physicians were working with a slew of residents, and we all reviewed our mental checklists and tried to enter our objective frames of mind. Organized frenzy.

My partner requested to be the lead physician during the resuscitation. Being young and recently-trained, he wants to save the world. We all want to save the world, I guess, but for now we'd focus our energy on saving this child. I assured him that I would stay in the room and help with the resuscitation efforts.

The ambulance arrived. With a sad nod of his head, a trusted paramedic gave answer to our searching faces. No response. Yet. We all caught our breath as our hearts plummeted.

We transferred this child to our hospital cot. We emergently intubated this child, checked for any pulses, and continued CPR when we found none. IVs were hard to establish, so I started an intraosseous line by sticking a needle into this child's left tibia. Aggressive fluids were given. Medications were administered. Ventilations were forced into uncooperative lungs.

Efforts continued. My partner followed the life-saving protocols but didn't get any response from this child. Prayers were whispered. Seconds were watched as they ticked on the clock. Slowly, as slow as any time had ever passed, a heartbreaking realization permeated the room. We might not succeed.

My partner ran to the family room to discuss options with this child's parents, while I continued to follow all the resuscitation protocols. We had nearly maximized all of our medications. And still...nothing. CPR was continued, ventilations were continued, more medications and hydration were given.

My partner returned to the treatment room. He looked at me expectantly, and I shook my head "no." My partner shared his conversation with me. Dad was still at work, and Mom was in the family room with our social workers, waiting for family to arrive. She had been invited back to watch the resuscitation efforts, but declined. Her child had been through this once before, because of chronic, ongoing medical problems, and had survived. Surely, she thought, her child could survive again.

After almost an hour of failed heroics, with absolutely no response to any of our interventions, we confirmed what we were most afraid of. There were no palpable pulses. There was no cardiac activity, confirmed on monitor and with our bedside ultrasound. There were no spontaneous respirations. There were no signs of life from this child.

There would be no miracle.

My partner asked if anyone in the room objected to his prounouncing this child's death. Nobody objected, since we had all been involved in trying to save this child's life. We knew the efforts that had been put forth were monumental. No attempt had been spared by our team to bring this child back. Unfortunately, and for unexplained reasons, the fates held different plans. My partner announced the time of death.

I requested a nurse to clip some of this patient's hair for the family. I crossed myself after my silent prayer. I fought my tears. Hell, we all fought our tears. I consoled my partner, who, like me, has three young kids of his own. Slowly, a wave of profound sadness and nothingness swept across us. What good are any of us if we can't save a child's life? My partner went out to the family room to deliver the awful news.

Then, time stood still. From two hallways away, I heard the haunting sound. A sound that I knew was coming. A sound that is played over and over in my mind for days after an event like this. A sound of profound anguish. A sound of utter disbelief. A sound of infinite pain.

A mother's cry.

Slowly, as we all knew would happen, the mournful wails of crying crescendoed, and our emergency department came to a stand-still as Mom was escorted through our halls into her little child's room.

Despite our best attempts at maintaining our objectivity, and despite the fact that there were many more patients waiting to be treated, our ER staff cried collectively and gave consoling hugs to one another. We are mothers. We are fathers. We are brothers and sisters. We are sons and daughters. We are friends. We are human. And, we were broken.

Dad arrived just minutes after Mom was escorted to the room, and the cries of desperation were repeated. This time, husky and deep. Slowly, though, his cries softened and dissipated, until there was but one lone cry that began again. Higher-pitched. Guttural. Primitive. Emanating from the womb. A cry that conveyed the raw anguish and helplessness that only such a profound loss as losing your child could bring.

God Bless this mother. God Bless this father. God Bless this child. And may God Bless and watch over this family. And all of us.

If only life were filled with just happy moments...As always, thanks for reading. Next post will be either Friday, February 19, or Monday, February 22. See you then...