Mullberry Whine

poured out before bed

Going Home

Woman with a Parasol and Small Child on a Sunlit Hillside, by Jean-Auguste Renoir (1841-1919)…

“The prognosis is not good.  I’d rather not keep him in the hospital for piddly reasons.  I want him home – enjoying his family for the remainder of his very few days.”

The attending looks softly at the circle of colleagues, fellows, residents, interns, nutritionists, various therapists, and students about him.  I cannot meet his eye.

We all know his condition is terminal.  We all understand that his organ systems have become so damaged from a misfortune-laden life measured in mere months, so dysfunctional with every growing insult that it is only a short matter of time before some great derangement takes the smile from his sallow cheeks, the twinkle from his icteric eye.

We just don’t talk about it.

Now, here we are on rounds, the whole peds GI team nearly 20 people strong, discussing in the busy hallway how this little soul will soon be called to a different sphere.  I think of how his minikin fingers wrap around my thumb each morning when I listen to his tiny, murmuring heart between the tubes and lines that help to support his fragile being.  I think of how he alternately snuggles into my arms and babbles his all-encompassing fascination with the stacked name badges and access cards fixed to my scrubs when I find time to help with his rare PO feeds on night shifts.  I think of the sweet, shy smile and hiccupy giggle he bestows on all his visitors, even the nurse presenting for the dreaded dexi finger stick. I think of the mutual adoration between him and his quiet mother, between him and his careful big sister, between him and his stalwart father, how I daily watch them interact with an unspoken agape and perseverance.

To think of him cold and unsmiling, of them moving sadly on without him brings tears to my eyes.

Dr. GI-guy shakes his head.  “This syndrome is such a bad one.  I would never wish this on my worst enemy.  But such a shame to happen to such a fine family, a very joyful little boy.”  The night nurse next to me sniffles.  I put my arm around her and a sneaky tear travels to the end of my nose while I desperately work to swallow the rest.

Just then the hospital room door we are gathered about opens and that quiet mother stands before us with that joyful little boy, that stalwart father behind them, his arm about her waist.

“Good morning, team,” she says with a true grin.  “Is today the day?”

Dr. GI-guy pats mother’s shoulder, tickles baby’s thin cheek, shakes father’s hand.

“Yes, today you take this little one home to enjoy.  We will have the discharge paperwork and your prescriptions finished shortly, but there is no rush to leave – you take your time gathering your things.”

Mother smiles and shakes her head.  “There isn’t time to dawdle with this one.”

Twenty people swallow hard, but mother moves on with little pause.  “We’re off to our favorite park for a walk and a picnic.  He’s been here so long I’m sure he’s forgotten what green and sunshine look like…and I want him to have that.”

“That sounds perfect,” Dr. GI-guy smiles approvingly.  “Then I will say my good-bye to you now.”  Mother transfers baby to father and hugs Dr. GI-guy, squeezes him tightly, whispers an honest thing made harsh by emotion in his big hairy ear.  She wipes away a tear and cradles her precious son as Dr. GI-guy and father start with a handshake that turns into the most un-awkward man hug in the history of man hugs.  Humbly, quietly, Dr. GI-guy asks if he may hold their child for a moment, and he smiles and plays with that tiny boy for a long while, tenderly hands him back to his loving parents.  Mother and father stand side-by-side, our favorite little patient between them, and look over the whole team, shaking hands and extending individual thank you’s to the members involved in their son’s care.

I will forever recall the presentation, the pathophysiology, the management of the disease that affects their sweet son.  I cannot forget its many complications and sequelae, most of which I witnessed firsthand in this one unfortunate child.   Yet, more vivid in my mind will be the time I have spent with him and his inexplicably beautiful family.  What I will most remember is that brilliant art of shared love and kindness which so effortlessly embraced a terrible situation, making it memorable not for it’s cold sadness, but for it’s surreal infusion with warmth and light.

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This entry was posted on March 21, 2012 by in Greiving, Med School Musings, On Pediatrics, Sharing and tagged , , , , , .

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Nothing under the table.
***
The views expressed on "Mullberry Whine" are NOT intended to diagnose or treat disease.
***
The med-ed related stories described here are based on real events. Details have been changed in accordance with HIPAA de-identification guidelines to protect confidentiality.
***
Mullberry Whine can be enjoyed daily; there is no unsafe quantity. Real wine, though, should be enjoyed in moderation. At-Risk Drinking for males under 65 is defined as >14 alcoholic beverages per week or >4/day, with >7 drinks a week or >3/day being the cut-off for females under 65 and for anyone, male or female, who has graced this planet for 65 years for more. Drink Mullberry Whine like there are no consequences. But drink alcohol responsibly. Your friends, your family, your health-care provider, and your liver - heck, ALL of the organs in your body - will thank you.
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