by Unknown
Kara, an eight-year-old girl suffering from kidney failure, had been admitted a week ago due to blood poisoning. The dialysis was barely having any effect on the condition and her parents seemed to be at the hospital day and night waiting to hear about a donor or some other medical options. Despite her condition, Kara was a spirited child whose quick-whit and timely sarcasm amused the hospital staff. She was one of my favorite patients to visit. Since this wasn’t Kara’s first hospital stay, she and I had bonded quite a bit over conversations about fashion and soccer, which Kara played when she was well. There was something about her that reminded me of my little sister and that drew me in. Today’s check-up was different. Kara was listless and her color was muted and dull. “Hey Dr. Porter,” she said barely above a whisper. “I’m not feeling too hot today. My parents have been fussing over me all day touching my forehead and having the nurses come in and check me. I told them I just feel tired, but they don’t believe me. Would you please tell them that it’s ok and some days I just feel tired? I heard I’ve moved up a few places on the donor list. Well, nobody actually told me, because you know no one talks to the sick kid, but I heard another doctor telling my mom in the hall. I think it’s funny that they think because I’m sick I’m going deaf! I hear a lot and I see a lot but mostly, I can always tell what’s going on by the looks on people’s faces. Today everybody looks worried and I don’t like it.”
Kara was a talker so I just waited patiently for her to finish her rant. This really is my kind of kid. I smiled to myself. She was quite intelligent and precocious for her age and I always enjoyed hearing what she thought and how she felt. Kara was a straight shooter and I loved that about her. The hospital staff and Kara’s parents didn’t really focus a whole lot on engaging her because they were all too busy fussing over her, but I knew she needed someone to talk to, so I padded my schedule to give her extra time whenever she was admitted. I knew it wasn’t the best move to get too attached to my patients, but Kara tugged hard at my heart strings. If she was there, I made sure she received whatever she needed. Today, what she needed, was to vent.
“I know I’m only 8 and I may not know more than eight years-worth of stuff but I feel like I’ve had a whole lot of experiences that other eight year olds haven’t. My friends don’t know anything about hospitals or dialysis or kidney transplants. At least, they didn’t before all this stuff happened to me. They won’t come around because they’re afraid to make me sad or maybe because I make them sad, I don’t know,” Kara looked down at the white bed sheet she was twisting in her fingers as she talked. “I just wish they could come and see me and we could hang out like we used to. Everyone here is so serious and concerned all the time. I just want someone to play with!”
I looked down at the chart in my hands long enough to pull back the tears that were dampening my eyes before I returned my gaze to Kara. “I’ll try to work on that for you, okay?” I assured her with a warm smile.
“Ok Dr. Porter, I know if you say it, you’ll really try!” Kara’s face lit up despite her weakened state and that made me smile a bit brighter.
“Alright Miss Kara, you get some rest and I will be back to check on you tomorrow.” I jotted down some notes about her vitals and gave her parents a nod before I walked out and closed the door behind me.
I was in my office reviewing charts, returning calls and checking hospital lists for potential kidney donors when my pager went off this time. I bolted for the ICU and found the seven-year-old whose surgery I’d completed in a fit of convulsions. She’d spiked a tremendous fever that could only be indicative of an infection. It couldn’t have been from the surgery, it came too quickly. The fever had induced a seizure so I ordered she be administered a drip antibiotic and a fever reducer. I also had Angie draw some blood and have it sent to the lab to determine whether there was any other illness going on that we weren’t made aware of. I decided to stay in the room until her temperature was regulated and I was sure she wouldn’t seize again.
Once the little girl, Cassidy, was resting and stable, I left her sleeping and went to find her parents. I had gotten word that their injuries were minor and that they were stable so I couldn’t understand why I hadn’t seen them or heard anything about them visiting their daughter. As I approached their room, I could see them laying in beds side-by-side and having a low conversation. “What are we supposed to do now?” the father whispered in a strained voice. “We already didn’t have enough money to take care of her and now we’re gonna have all these hospital bills to pay.”
“I know! No one planned for any of this Evan! We’ll just have to find the right time to get out of here,” the mother replied equally distressed. I cleared my throat loudly to make them aware that I’d entered the room and watched as they shifted nervously in their beds as though they’d been caught doing something. I got down to business and updated them on their daughter’s status. “She’s stabilized now and we put her on a stronger dosage of antibiotics to keep away any additional infection or fever. If you two would like to see her, you can do so at any time. I have given the nurses on staff specific instructions to wheel you to her floor when you’re ready.” I scanned their faces for some look of concern, relief or excitement, but all I saw was nervousness and fear. I continued on. “Also, does your daughter have any sort of virus or infection that you two are aware of? It isn’t common that a patient would spike a fever so quickly after surgery so is it possible she may have already been ill?”
“Actually, we were on our way to the clinic when we got into the accident. She has had a fever for a couple of days and the fever-reducer wasn’t working so we were going to have someone take a look at her.” The couple continued to exchange nervous glances and finally when their eyes settled on me I reiterated, “Alright, so, just let the nurses know when you’re ready to go and see your daughter. The surgery was successful by the way.” It came out with more attitude than I intended, but I was annoyed that they didn’t seem overly concerned about the condition of their daughter after surgery. They were concerned enough to take her to the clinic but don’t flinch to find out how she’s recovering from surgery? Something doesn’t add up. I stopped by the nurse’s station on my way back to Cassidy’s room and told them to keep an eye on the couple because they sounded like they could be planning to run and I wasn’t certain they planned to take their daughter with them.
As I sat in the room with Cassidy, I was steeped in emotion. How could they not even come to see about her? Skipping out on medical bills was one thing but abandoning your child? I really hoped I was jumping to conclusions and what I heard was just a misunderstanding. What options would Cassidy have if they did up and leave? It all got me thinking about Emily. She was the exact same age when she died. I would have given anything to have more time with her and to watch her grow up. What would her life have been if she’d been given the chance to live it? If I feel this strongly for my sibling surely, Cassidy’s parents feel as strongly about her. I bolstered. Still I couldn’t shake the feeling. I needed to be sure so I hopped up from the cushioned arm chair and headed back to Cassidy’s parents’ room.
To my relief, when I arrived they were still there. “Hello Mr. and Mrs. Blue. I wanted to come back and discuss some things with you regarding the medical care for your daughter. I happened to hear you discussing your concerns regarding the hospital bills and I wanted to assure you that we will work with you and can provide you with several options to help you pay the bills. It’s important that you complete some paperwork for our financial counselors so that they can look into getting you some assistance. Did you have any other concerns beyond the hospital stay? Perhaps there are some other resources we can assist you with as well.” I wanted to be sensitive in my approach at getting more information since they seemed so skittish. I needed to get them to tell me more about their long-term plans beyond the hospital stay.“Well,” the mother, Marie, began to respond as she looked at her husband with an unsure glance, “We have been having a hard time financi
ally since we moved here from Flint, Michigan a year ago. We had hoped to have jobs by now but we haven’t had any luck and Evan’s unemployment just ran out. We could definitely use some help. We want to keep Cassidy with us but with our financial situation we may have to send her back to Flint with my mom.” I listened intently as I worked toward coming up with some viable options for them. I had been wrong about them. They were just a couple in a financial bind. I could work with that. I ignored the lingering questions of why they hadn’t even asked to see their daughter or inquire about how she was. Instead, I focused on trying to equip them with resources to help keep their family intact.
“Have you applied for any public assistance -public housing, medical coverage, or food services? There are a lot of programs that you may be eligible for since your income has gone down. I could have the hospital social worker come and let you know what your options are. You can even apply right here in the hospital.” Again their faces filled with uncertainty and I knew I had spooked them with the mention of a social worker. Shit! I tried to backpedal a bit hoping to put them at ease. “Better yet, I’ll just get the paperwork and bring it back here for you to complete. That way while you and your daughter are here recovering we can have some things already in the works. Does that sound alright?” Their faces relaxed a bit so I continued. “I’ll be right back with the paperwork.” They nodded their approval as I exited the room in the direction of the hospital social worker’s office.
On my way there, I saw Kara’s parents and several of the nursing staff gathered in the hall. Her parents were visibly shaken and distraught. My heart dropped into my stomach as I locked eyes with one of the nurses. The look on her face was one I knew too well and could never forget. Kara was gone. Before I could make good on my promise to bring her friends, she was gone. Before I had gotten the chance to say goodbye or even attempt to save her life, she was gone. I quickly wipe the tears that escaped my eyes and went over to Kara’s parents.
“We want to thank you for everything you did for our daughter, Dr. Porter. She thought so much of you and she felt like you were a friend to her when she was here. Thank you for helping our baby not feel alone while she was in the hospital. We know that you did more than you had to for her. For that, we are beyond grateful.” With those words, Kara’s mother turned and collapsed onto her husband’s chest and erupted in a wave of intense, heartbreaking sobs. I was at a loss for words and even if I’d had any, they wouldn’t have been sufficient. No words could ever replace their child or ease their heartache. Instead of heading to the social worker’s office, I went to my office, closed the door, sat at my desk and sobbed. This was the part of the job I hated most. I always questioned whether I had done everything I could to heal or save each child I lost, and there was always the pang of sadness that came with the thoughts of my own sister’s passing. Today it was all too much.
Without thinking, I grabbed the receiver of my desk phone, called Josh and told him everything that happened. “I’m heartbroken.” I said between sobs. “I know this is a part of what I signed up for but today… I just can’t deal.”
“What do you need me to do?” he asked.
“I . . . I would really like to see you tonight. I just don’t want to be alone,” I pleaded. I wanted to tell him that I needed him to hold me and make me feel safe. I wanted to say that I needed him to tell me it would be alright and to stroke my hair while I cried in his lap. I needed him to kiss away my tears and to let me fall asleep in his arms. I wanted to tell him all those things, but I couldn’t bring myself to say any of it.
Josh’s voice parted through my clouded thoughts. “Ok babe. I’ll come over tonight when you get off. Don’t worry about dinner or anything. I’ll bring it to you or we can order in if you want. Let me know what you want to do when you get off and I’ll make it happen. Don’t worry. I’m here. See you tonight.”
I sat there with the receiver in my hand, trapped inside my own head until the phone let out an annoyed blare urging me to hang it up. Pull it together. You still have other patients. Once I regained control of my senses, I got up and walked to the social worker’s office. She wasn’t there so I grabbed some pamphlets and the necessary paperwork from a rack there in the hall and headed for the Blue’s room. My emotions were high and panic was setting in. I couldn’t shake the feeling that this couple was going to run out on either their bill, their daughter or both. I rounded the corner and headed straight down the corridor to their room where I found two empty beds. I turned to the nurse’s station. “Ashley, where is the couple that was in this room?”
She looked up casually, glanced in the room and said, “I don’t know. They were there a while ago.” I could feel the blood boiling beneath my skin.
“I gave specific instructions that they were to be monitored because they seemed that they might self-discharge and run!” I seethed. Shit! Cassidy! “Check the log and see if Cassidy Blue is still listed as admitted here.” I watched Ashley’s fingers click rapidly against the keyboard as she searched the screen.
“Yes, it shows she’s still here.” Before she finished her statement, I was at the elevator.
I got to Cassidy’s room any flung open the door expecting to find Cassidy alone, but to my surprise her parents were there. Her father was sitting in the armchair where I’d been most of the day and her mother was sitting next to her stroking her hand. Relief washed over me and I took a deep breath and attempted to collect my thoughts and emotions. I was grateful to find them all there together. Two tragic events in one day would have been more than I could handle.
Mr. and Mrs. Blue turned their attention to me. “We thought it was about time we came up here to see our baby girl!” About time is a damned understatement! I thought. It had been nearly the entire day! “Doc,” Mr. Blue said. “She sure is sleeping pretty hard and what are all these things you have running in and out of her? Is she gonna be alright?” He glanced in Cassidy’s direction. “I know we came off the wrong way earlier. We’re having a rough time, but we love our little girl! You said you could help us and we sure do need it. We want to stay together as a family.” His wife nodded her agreement. “When you left we got to thinking about how we could make our situation better, you know, for Cassidy’s sake. We want to fill out all your papers if it will help. Our car was totaled in the accident so that’s just something else to deal with, but that’s not your problem. Did you bring the papers?” I was more than happy to hand them the papers and walk them through the completion process. Before I left that evening, I had helped them apply for food assistance, medical assistance and had pointed them in the right direction to get housing assistance, as well. I handed Mr. Blue my card.
“I’ll get you each a one month bus pass to take with you when you discharge. Be sure to call me if you need help with anything. You two take good care of Cassidy and yourselves, alright?” Mr. Blue shook my hand and thanked me repeatedly before I departed. The outcome of the situation made me feel a bit more at ease about everything that happened throughout the day. Helping the Blue’s somehow took a bit of the sting out of losing Kara. I lost a patient, but I also saved a family today. I couldn’t call it breaking even, but it gave me a little peace.
Chapter Six
I had just curled up on the sofa in my pajamas when the doorbell rang. When I opened the door, he stood there, searching my face. His expression was a mix of concern and affection. “Come on in.” I stepped aside and he walked through the door way, Chinese takeout in hand.
“Should I take the food into the kitchen or the living room,” he asked.
“You can put it on the coffee table in the living room. I’m not really hungry.” As I looked up at him, hot tears instantly flooded my already bloodshot eyes. He put the bags down and wrapped me tightly in his arms. I nuzzled into him as close as I could and laid my head on his chest and cried. The feel of his hands up and down my back soothed me but still I couldn’t stop weeping. Before I knew it his cotton polo was stained with my tears and my head
was beginning to ache.
“C’mon, let’s sit down,” Josh coaxed as he moved me toward the sofa. He sat down and I laid my head in his lap. I tucked my knees into my chest and closed my eyes as I felt him rhythmically stroke my hair. Deafening silence filled the room save the occasional sob that escaped my lips. “Do you want to talk about it,” Josh asked softly.
“Not really,” I whispered. “At least not yet. Even though she was my patient, that little girl was special to me. The fact that she’s gone is stirring up a lot of things in my mind and heart that I’m just not ready to deal with yet.”
“Ok, we don’t have to talk. I’m here if you need me,” he said as he continued running his hands over my hair. I had to admit it felt good to have someone to lean on, and Josh was exactly what I needed. He wasn’t asking for anything. He was fine with just letting me be in my feelings and waiting for me to share them when I was ready. It felt so easy with him. There were no expectations or hidden agendas. Even though I was vulnerable at the moment, it felt safe with him. He wasn’t there to take advantage of my weakness. He just wanted to support me through it.
I turned over to face Josh and his eyes met mine as he brushed his fingers against my wet cheeks and wiped away the remnant traces of my sadness. “You ok,” he asked tenderly.
“I’m feeling a bit better than I was. This was just a very hard and sudden blow. I saw the little girl this morning and then she was just gone! It stirred up a lot of feelings about the loss of my sister. I think that made it even harder.” I sat upright and tucked my feet beneath me, pulled the ponytail holder from my hair and shook it loose hoping to relieve some of the now pounding pressure in my head. Reaching down into the plastic bag on the table, I dug out a smaller bag that contained two spring rolls. I offered one to Josh and grabbed the other.
“If you don’t mind me asking, what happened to your sister,” Josh asked tentatively before taking a healthy bite of the roll. He hadn’t really asked me anything truly personal until now, and I paused at first. I felt a tinge of uncertainty about sharing something so private with him. Sensing my hesitance, Josh reached for my hand and gave it a squeeze. “You don’t have to tell me if you don’t want to. I’ll understand.”