by Dianne Drake
“I am, but I’ll get over it. I always do.”
“Want to come over for a glass of wine or some coffee or something? Charlie went down early so I’ve got some time to myself this evening.”
“That’s nice of you but you don’t need to feel sorry for me. I told you because you needed to know, not because I was looking for some sympathy.”
“How could I not sympathize, though? That’s my nature, why I became a pediatrician. I have great sympathy for children. Kids are great. They don’t complain, they’re brave, they do what they need to do without making a fuss over it. I fell in love with the field my first day in and that was that.”
“Pretty much the same with me. I intended to be an anesthesiologist but this is what worked out for me and I’m glad it did. Kids are fun to treat most of the time. After my divorce and before I came to Lakeside Clinic I was doubting my choice a little, thinking maybe I should go back and become a pediatric anesthesiologist or specialist in something like pediatric oncology. Something to change my life. But that was all because I’d lost Amy and she was like my compass in a lot of ways. Then I came here and realized I’m where I belong. No turning back. No changing.”
“Well, it’s never too late to change, if you’re thinking about it. Nothing wrong with shaking things up.”
He chuckled. “I think I’ve got a little too much water under my bridge to change my field at this stage of the game. Besides, I like what I do. General care is good. It’s what I want to do because I like the interactions as well as the dynamics of the whole field. And in a day and age when so many people are specializing, or where so many family-care practitioners are seeing children, I think the place of the general-practice pediatrician is more needed than ever. Besides, kids are fun.”
“Give it some thought, though, since it’s still obviously on your mind. Lakeside has a good anesthesiology program. Then there are other hospitals with equally good reputations, as well.”
“I’ve given it a lot of thought, but I’m where I want to be. Either in a clinic or in the ER.”
“Well, you’re good at what you do, and if you’re happy there...” She quieted for a minute, then said, “Could you hang on for a second? I hear Charlie crying, and I’m not sure he’s feeling so well this evening. I’ll be back on in a minute.”
“How about I let you go and I’ll see you tomorrow?” he responded. “Charlie could take a little while, and I don’t want to rush you.”
“Tomorrow,” she said, then hung up, smiling. It was nice having Simon for a friend. Although it did make her wish she had room in her life for something more.
* * *
For the first time in her motherhood experience, except for one brief exception, Charlie slept all the way through the night, which should have elated Del but actually it bothered her. He was restless, kept himself curled into a ball with his little legs drawn up to his chest, and didn’t get the restful sleep she’d hoped he would. Then when by morning he was still fussy she knew he definitely wasn’t feeling good. But another preliminary check showed him to be in good shape. No cough, no runny nose, no fever. Just grouchy again, and he definitely didn’t want to be held, which was unusual. He also refused to eat. In fact, he threw his bowl of oatmeal on the floor, which was, perhaps, the most alarming thing of all as Charlie had a pretty hefty morning appetite and loved his oatmeal and bananas. So rather than taking him to day care first thing, she took him to the clinic to get an unbiased opinion of what could possibly be wrong since she had a suspicion she knew and it was best not to treat him herself. Not that she could, if she was right about this.
“Simon,” she said on the way in, “would you mind looking at Charlie for me and seeing what you can come up with? He started acting fussy last night and, while I have my suspicions, I’d rather not be the one diagnosing him.”
“Take him to Room One and I’ll be right there,” he said as he slung on his white lab coat and followed her into the exam room. “So what are his symptoms?” he asked, listening first to his chest, then his tummy.
“Fussy, won’t eat, doesn’t want to be held and he balls up in a fetal position when I put him down. He was fine last night. Slept all night, was a little fussy when I put him down but he didn’t display any overt symptoms.”
“Knees drawn up to his chest?” Simon asked.
Del nodded.
“Has he ever had an intussusception?” This was a condition where intestine folded into another section of intestine, much like the way a collapsing telescope folded up into the section in front of it. In and of itself the condition was not serious in the first couple days but it did carry with it a risk of surgery if not treated soon enough. Especially if an intestinal blockage occurred.
Del sighed out loud and her hands started to shake. “No. Did we catch it in time or will he need surgery?”
“If his symptoms just came on him last night or this morning, he’s probably a good candidate for treatment without surgery.”
Del brushed back a tear. “I didn’t miss it, did I?”
Simon shook his head. “You brought him in as soon as he presented with symptoms. Don’t second-guess yourself, Del. Babies have no way of telling us what’s wrong and if he’s not showing symptoms, you can’t just guess there’s something wrong or you’d drive yourself crazy. You were observant and you did the right thing as quickly as you knew.”
She brushed back another tear. “It’s so difficult sometimes. So many things could go wrong.”
“And so many things could go right.”
“I guess so, but when it’s your child...” She shrugged.
“You’re a normal mom, doctor or not. And most moms would be scared by the diagnosis.”
“So how are you going to treat him?”
“Conservatively at first. I’d like to start with an ultrasound followed by an abdominal X-ray just to make sure that the bowel hasn’t gone necrotic. And we’ll go from there. But he does need to be hospitalized for the procedures and to be watched for a day or two. You do understand that, don’t you?”
She nodded. “He’s going to be so frightened.”
“He may surprise you. One of the reasons I like kids so much is that they take things better than we do. If someone told me my intestine was twisted up I’d be in a panic, but Charlie will just accept things as they come his way.”
“He will, won’t he?” she said, trying to muster up some conviction in her voice even though she was scared to death.
“Look, Del. You’ve seen this before and treated it. It’s usually not a complicated procedure once the diagnosis is confirmed.” He prodded Charlie’s belly for a mass and sure enough, there it was. “You know the outcome is good in most of these cases. And if he does need to have surgery, it’s a relatively simple procedure.”
“I’ve treated it, but never in my child. He’s always been so healthy.”
“And he still is healthy,” Simon reassured her. He was thinking back to when Amy was sent home from school with the measles. He’d been on call and hadn’t seen much of her for a couple of days, then to see his daughter all covered with a rash the way she was—at first he’d been angry that her mother had allowed her to go to school that way, then he’d turned his concern to Amy, who had been one mighty sick little girl for a few days. He’d felt so helpless and vulnerable because there really had been nothing to do for her except sit with Amy and help her ride out the illness. Because of that, he knew how Del was feeling and his heart went out to her because she, too, was feeling so helpless and vulnerable right now. And blaming herself.
“So here’s what I propose,” he said to Del. “First we get him admitted to the hospital and get the diagnosis over with, then we discuss the options. And even though you know, it falls down this way. He’ll be treated with either a barium or water-soluble contrast enema or an air-contrast enema, which wi
ll confirm the intussusception, and in the best possible scenario reduce it. The success rate is pretty good—about eighty percent. If this does recur, it should happen in about twenty-four hours, and that’s when a surgeon will open the abdomen and manually squeeze the part that has telescoped. Or the surgeon may choose to reduce the problem by laparoscopy. Any way you go, it’s going to be more stressful on you than it will be on Charlie. Best case scenario puts him in the eighty percent category and he’ll be home in a couple of days. Worst case is surgery, which means he’ll be here a little longer than that.”
“I appreciate you going over this with me. Of course I know it, but right now I’d be hard pressed to tell you my name let alone anything else.”
“It’s Del,” he said, smiling.
She smiled. “Will you be there during the tests and/or surgery?”
“If they let me. And if you request it.”
“I’ll request it,” she said, “because I don’t want him to be alone, and I know they won’t let me anywhere near him while they’re doing whatever it is they’ve got to do.” She looked at her little boy lying there on the exam table all drawn up in a ball, then bent and kissed him. “I’m trusting you with my son, Simon. He’s the best thing in my life and I’m handing his care over to you.”
Simon swallowed hard. He knew what it was like to surrender your child. “I’ll take good care of him, like he’s my own.”
“I’m counting on that,” Del said as she reached out and took hold of Simon’s hand and held on for dear life. “I’m really counting on that.”
CHAPTER SEVEN
THE PROCEDURE TOOK longer than she expected and it was nice having Simon sit there with her, holding her hand at first, then holding on to her when her nerves finally got the best of her and her whole body started shaking. “It’s so much worse when it’s your child,” she said, fighting back tears of fear and anguish. “Even though I know he’s getting good care.”
He ran his thumb over the back of her soft hand. “He’ll be fine,” Simon reassured her, even though she didn’t feel much as if reassurances were going to work.
“Sure. But still, suppose this doesn’t work and he has to move on to the next step, which is surgery?” She grabbed hold of his hand and clung tightly to him. “I don’t know if I could get through it, the thought of them having to remove a piece of his intestine. That’s so serious. And the risks so great it scares me to death. I mean, what if...?”
He stroked her cheek. “One thing at a time, Del. That’s what I always tell the parents of my patients. We’ll deal with one thing at a time, get through it and hope for the best. That’s all you can do.”
She exhaled a big, wobbly breath. “Easy to say when the shoe is on the other foot. But when it’s on your own...” She shut her eyes as the tears streamed down her cheeks. “When it’s your own child it’s different. He’s my flesh and blood, Simon, and he’s suffering. But there’s nothing I can do to fix this. I’m the mother. I should be taking care of him.”
“You can’t just center your entire life around what he wants or needs. You need to have something in there for you, too, and that’s your medical practice, no matter how hard it is to be a single parent as well as a full-time doctor. It’s called balancing your life.”
“But how did you do it?”
“It wasn’t easy, and I’ll be the first one to admit that. Amy came first, but my medical practice had its place in there, as well. I learned to balance it so we were both happy.”
“How?”
“First, by realizing that I was happier having a life in medicine than I was without it. When I was happier, Amy was happier. I think by balancing myself I evened out everything for the both of us, which was difficult because the older she got, the more she recognized that her mother simply didn’t care enough to be involved. Which made for some awfully moody moments. Except, she always had me and she counted on that. I just had to make sure I never missed out on the important things going on in her life. That was the tricky part, too, I’ll admit. Amy needed me, my practice needed me and for a while even Yvette needed me. I suppose you can say I failed Yvette, but I think she set up the situation between us to fail.” He shrugged. “There was nothing I could do about that, but I did have control over the rest of it, no matter how difficult it became. I just had to make sure that Amy never missed out because of anything else going on in my life.”
“I admire that in you, Simon. I’m not sure my priorities are that clear yet. For me it’s all Charlie and nothing else. Even my medical practice takes a backseat, which I know it shouldn’t. But Charlie is so important to me that I’d love to retire and stay home with him. And I might for a while except I know I’d miss my practice and wouldn’t be completely happy not working. It’s a real dilemma.”
“There were days I certainly hated walking away from Amy, so I understand.”
“But you figured it out.”
“After a while.”
“When I had Charlie I was fiercely adamant that I could have it all, and I didn’t count on the emotional turmoil I’m facing now. But there are days when I hand him over to day care that I’m literally so conflicted I don’t know what to do.”
“You do the best you can. That’s all that can be expected from any of us. And the thing is, you can have it all. You already do...at least all that you want.”
“What would I do if I did get involved with someone? Maybe even got married? There’s not enough of me to go around. I couldn’t do it.”
“Sure you could, if that’s what you wanted. You’d just have to marry the right person. The one who understands that you have this huge life going on already. He’d certainly have to be patient. You’d choose wisely.” He smiled. “Because you’ve had what you know you don’t want, I’m willing to bet you’ve put some thinking into what you do want.”
The surgery ward door pushed open and Del’s heart doubled its rhythm, but it wasn’t for her. Nothing to do with Charlie, but some other surgery waiters got a bit of good news judging from the round of cheers that went up.
After the noise of the happy waiters died down, she continued, “I’ve never really given it that much thought because I’m not sure anybody would want to handle my life, such as it is. It’s so full already that I don’t think I’d have room to add anything or anyone else. And I don’t want to get involved when those are my expectations.”
“But you could be missing out.”
“Or not,” she responded. “I mean, look at everything I’ve got. That’s enough to keep me busy.”
“But don’t you get lonely when you go to bed alone every night?”
“Don’t you?” she countered.
“I’d be lying if I said I didn’t. But I’ve got different standards this time. And I’m going to be very careful if I get involved again.”
“Let me guess. No women with children.”
He arched his eyebrows. “I’m not opposed to children. In fact, I’d love to have a large family. But I don’t want to be put in a position where the kids can be taken away from me. Next time I’m a dad, I want to be a dad for real.”
“Poor child,” Del said. “To count on someone so much then have him kicked out of her life.”
Simon shrugged. “And not to know what she’s doing. Sometimes I feel...lost.’
“But Amy lost, too, didn’t she?”
“I hope not, but I can’t help but think that she did. It keeps me up at nights sometimes wondering and worrying.”
“I wouldn’t do that to Charlie, which is why I’m happy just the way things are. But today...it’s not what I bargained for, and that’s stupid of me, considering how I’m a pediatrician. I mean, I know better. Kids get sick with all kinds of strange ailments and I guess I always thought I’d be exempt since I’m a professional in the field. But it doesn’t work that way, doe
s it?”
“Amy broke her arm once. She fell down a flight of stairs and the break was pretty substantial. Her mother was out of town, so that left me alone to deal with it and I don’t know when I’ve ever felt more helpless than I did when she was getting it casted. But she came through it better than I did, just the way Charlie will come through this better than you do. I promise.”
“Amy needs you as her father. Her mother did a really stupid thing taking her away from you.”
“I agree with you on that. I would have done anything for that little girl.” He shook his head. “Which is the reason I won’t date another woman with a child because, if something should come of it, I stand a very good chance of having that child yanked away from me after I’ve formed an attachment.”
“I can’t blame you. If someone came and took Charlie away from me...” She brushed back a straying tear. “Just call me an overprotective mother. I know I am, and I’ll admit it.”
“Nothing wrong with that. Better to be overprotective than to be Amy’s mother, who looks at her daughter as an inconvenience.”
“Well, Charlie’s not an inconvenience!” Del sniffed. “And I’d fight anybody who said he was.”
Simon laughed. He liked that attitude of a mother lion, wished he’d seen it more in his own home with Amy. But Yvette had never cared that much and she was always glad to give up the chore of child care to someone else so she could have her life to herself. Honestly, had he seen that in her when they were married, they wouldn’t have been married. But he’d been blinded by a great body and good looks, and back then he’d been too young to look any further. Now he knew, and he was on his guard against the type.
The thing was, Del could have been his type, as fierce as she was, but he wasn’t about to put himself into that position again.
“You’re a good mother,” he told Del.
“With a sick son. I’m so worried, Simon. I know there was nothing I could do but it’s still so easy to kick myself about it.”