It rains, it pours

1pm

In 29 years, this is the worst day of my life.

“He’s not doing well” they said, “the surgery went fine, but when they closed him up, his heart stopped…”

“…The machines weren’t reading correctly, they couldn’t pick up any blood pressures”

“…no spontaneous respirations, they can’t figure out what is going on”

“…the mom is with the chaplain, do you want to talk to her?” they asked, “do you want to go in there?”

“…he tolerated the procedure well until closure…”

“…the surgeon are sitting at the bedside, the anesthesiologist is manually breathing for him”

“…do you want to see him?” they asked, “…can anyone find his mother?”

“…nobody wants to call the death…”

The whole episode is such a blur, I don’t know who is talking to me, I don’t know what just happened. I have never felt so much like I couldn’t breathe, like I couldn’t gasp a single breath, like I was suffocating in my own body. There are children who are chronically ill, their deaths come as a slow and painful decline into the inevitable. There are the children who come in acutely ill, the ones who we throw all of our tools at, but their fates are determined before entering our doorsteps. All are horribly painful, so we mentally prepare for the chronic deaths and we mentally detach from the acute ones.

Then there are the children like Cedrik who walk around the sidewalks with goofy grins on their faces, with basketball bellies under their shirts. They giggle at the sound of your stethoscope in their ears and they share their fufu with you. They play “slap hand” before rounds and explore the compound in the afternoons. They have a mother and a baby sister who sit at the edge of a hospital bed at all hours. They enrich your life, your every morning, with an infectious crooked smile; they lighten your heavy heart when they walk up behind you and grab your hand.

Cedrik is the best thing that has happened to me since coming here, a youthful light in so much pain and darkness. I vomited when I heard the news, felt a deep squeezing pain in my chest. I can’t talk, I can’t think, I can’t eat. I can’t bear to see his mother, hear her wails. I am nauseous, defeated, overwhelmed, paralyzed. I’ve had the horrible misfortune of enduring far too many childhood deaths, but this one has truly shattered me.

I can’t believe that I won’t see his smiling face ever again, hear the sound of his giggles. So outwardly healthy and full of life, so much of a mischievous future he would have had. It is too painful to even think about his mother. He will never be a teenager, he will never fall in love, he will never know the joys of being a parent. I just can’t wrap my head around it. Playful and free this morning, lifeless by afternoon.

I didn’t see it coming.

I think it will be a while before I catch my breath, before I can pull the knife from my stomach. No one will make eye contact with me today. The surgeons look at the ground when they see me coming. Last night at dinner I told them, “be careful with him, he’s my favorite patient.” I wish I hadn’t said that.

And so this is life, I suppose, just a pericardium away from death. It’s cruel and horrible and unfair at times. Admittedly beautiful at others. But right now I’m having trouble seeing the rainbow through the monsoon.

3pm

Called to Derrik’s bedside—complaining of headache and then unresponsive. This morning he was fine, yesterday he was up in a wheelchair. Lifted his eyelids and felt my heart drop to the floor. Fixed and dilated right pupil. He had herniated- with no mannitol, no vents, no hypertonic saline, there was nothing I could do. I had to tell his mother that he was going to die soon and there was nothing we could do to save him. I held his hand and sat between the sounds of his agonal breathing and the wailing of Cedrik’s mother. All the children stared at the one child who was dying and the empty bed where another child used to be. Cedrik’s mother threw her body on the bed and refused to move. Derrik’s mother sat silently at the bedside with tears running down her face. The chaplain came and we prayed. I thought of the words my bravest friend had written to me:

God, grant me the serenity to accept things I cannot change,

The courage to change the things I can,

And the wisdom to know the difference. 

I will try to remember this, now more than ever.