The first time I saw Geoff, he was lapping the B level in a bright red wagon stuffed with pillows and adorned with stickers. His face was one that drew stares from the curious, and medical students are curious to the point of rudeness at times. It wasn’t until his second lap that I took stock of the woman pulling the handle. She had on two pairs of mismatched and brightly striped hospital socks on each foot, and her hair had struggled mostly out of her ponytail. She had a weariness in her shoulders.
“What does he have?” I whispered to my resident after the wagon had passed. “I mean, what is his underlying condition?” I tried to make my interest sound purely clinical. I know that the part of me that is drawn to the grotesque sounds distasteful when I allow it to seep into my words. “Is it Trisomy 18?”
“Trisomy 13,” she corrected me. “But it’s a mosaic form, so somehow he’s managed to live.”
The door to his room had a sign with his name on it, and each letter had been painstakingly cut out of some kind of foam. I didn’t know what the inside of his room looked like. Students were not permitted, by family request.
I knew his story anyway, because the details of his admission were discussed at morning report each day. His was a saga that spanned many weeks and its chapters had been told by many residents.
His mother presented his case to our attending in a way that would have made most students envious. She described the bruises from all of his IVs dispassionately, and suggested a G tube feeding change with the confidence of one well-versed in the mysteries of unruly bowels.
“Geoff lives here,” one of the second-year residents said later that week, and it occurred to me that I had no idea what his prognosis was, but that he could very well die here, too.
I thought of how his mother was with him every day and night, caring for him through her exhaustion because motherhood is not shift-work, is not a lifestyle specialty. Her being his best nurse was the first example to me of the beauty in the short lives of the rocks.
We accepted with resignation the moments that morning rounds led us to the rooms of the rocks. Their cases were complex, their families at times demanding, and their needs many. Their care took time and meticulousness that the straightforward orthopedic patients didn’t require. They were often the reason we were late to lunch.
Daniel was a 15 year old sickle-cell patient whose illness had reached a head when a bad case of osteomyelitis took root in his heel. He had lived an otherwise relatively normal life, with hospitalizations only about once a year for pain crises. After about two weeks of antibiotics recommended by the ID specialist, and no improvement in his foot, when the Hematologist started discussing transfusions with the family, students stopped going into the room. His mother could be seen writing notes in her bible in the afternoons. In the morning she took Daniel’s sister to school. I saw Daniel smile for the first time the day he was discharged. When I saw his name on our list again two weeks later for surgical incision and drainage of his heel, I felt as if my insides, too, were filling with sludge. If he was a rock, then he was good for skipping. But all rocks eventually sank.
Alice was a fourteen-year old girl with developmental delay and a recent spinal operation. Her recovery was complicated by infection, and the surgeon fought us on culturing her wound drainage until eventually a wound vac was needed. Her mother and grandmother were kind and understanding, and never made any demands. They called Alice “Princess.” Alice was a happy soul. When she wasn’t in pain, she often told her caretakers that she liked them.
I met Alice’s grandmother in the family area one day. She was struggling with the coffee machine, and to be honest, it really wasn’t an intuitive contraption. I struggled with it on her behalf because I have deep sympathy for coffee addicts like myself, and she thanked me profusely when a weak stream of light-brown liquid trickled out finally. I thought of all the family members who had suffered through the bad complimentary coffee that day, and that month, and that year, and the gravity of the children’s hospital seemed staggering to me at that moment. I was brought back to the present by a warm smile from Alice’s grandmother as she headed back towards Alice’s room. The sun was just coming up, and the sky was streaked with sleepy smudges of periwinkle gray and dusky orange.
It dawned on me at that moment that if all I had done to contribute to Alice’s care that day was help her grandmother make the coffee, it was probably enough.