Abstract
I
It is late in the morning and our service is busy. The patient census is full of the usual mix: those with end-stage cancer, the intensive care unit (ICU) players, the sickle cell crises. We are asked to control pain, or to discuss hospice services, or to help with discharge planning. Occasionally, the request made is less certain but equally comprehensible: “Help us deal with the brother from out of town.” I try to remember everyone's name, but it is easier to recall underlying diagnoses and the dramatic events inciting this hospitalization.
I glance at my watch—nearly lunchtime and we are barely halfway through the list! An intern takes a very long time presenting a very straightforward patient. He has worked hard to organize the medical history and sift through the details. He has a good plan for this patient today. I think: he will make a good internist. I think: maybe I will get a chicken salad sandwich for lunch.
We stand outside a quiet private room and listen through the heavy door. We can only hear murmurs from within; someone is crying. Since the rest of the team has already been here today, I send them on to the next patient. As I open the door, I am immediately confronted by the bed curtain. I gently peel it aside to find my patient lying very still, very quietly. I count the 10 or 15 seconds between his breaths. I see his elderly mother sitting by the bed, the family Bible on her lap. We seem to recognize each other.
“This should never have happened,” she says. She is right.
Down the hall, the team is paging me again. They are ready to break for lunch.
II
It is obscenely bright outside. The sunlight cuts through broad thick glass panels, tearing around hastily pulled shades. I have worn this t-shirt and these sweatpants for 2 days now.
I am in a different room in a different hospital. This room is so big—too big for just this lumpy hospital bed, a few awkward chairs, and us. It is mid-afternoon and the meal trays have been removed. No one wanted to eat chicken fingers and applesauce. No one wanted much of anything.
My wife takes a turn sleeping in the bed. It is not a deep restful sleep—just a pause during the quiet between people coming in and out of the room in yellow isolation gowns wheeling monitors and blood pressure cuffs, carrying bags to hang from our child's IV pole. We have not really slept in 2 days.
I sit in a chair, next to her, with our 4-year-old daughter lying on my lap. Over and over we watch Tinkerbell and the Lost Treasure. Our child gazes at the television intently but always with an eye on that heavy door. She anticipates the poor phlebotomist charged with finding another thin vein. I gaze at her, still in shock at how this could have happened—tiny immature cells replicating endlessly in her bone marrow, empty of purpose or meaning. Outside the room I hear voices of the staff chatting, something about the imminent weekend and chocolate cupcakes.
In just a moment, I will gently lay my daughter back on the bed to rest with her mother. I will walk to this big heavy door and open it and step out into the bright hallway and I will scream, How can you talk like that?! Do you not see what is happening here in this room?! Do you not see this child tied to lines and machines?! How can you think about weekends or cupcakes or anything else?! Any moment now, I will do this.
In the end, I do not move from that chair. I sit quietly and hold my child and wait.