I need a break. From life. From men, and definitely from my patients dying. Or becoming orphans. Winter has not been kind to the NICU/PICU kids. There’s been a horrific pertussis outbreak. The pediatric cardiac PICU opened up with it filling up on day one. There’s even been a spate of random accidents that has caused kids to end up in the hospital.
The other night I literally broke down when I went to check on pre-school aged patient named Xavier and found his school aged sibling in bed with him reading Harry Potter to him.
“Hey buddy. What are you reading?” I asked the big brother.
“Harry Potter and the Sorcerer’s Stone” he answered. “It’s about a boy who finds out he’s a wizard when he turns 11. Did you know that I’m 10 and a half?”
“I did not know that” I mused to the big brother.
“I’m in charge now so I gotta make sure Xavier knows how to read.”
“Why are you in charge? You are not an adult.”
“My mommy and daddy were in the accident too. They were coming to pick me up so I’m OK, but their car got smashed”
“Are they in the hospital too?” I inquired because it was now a little alarming that a 10 and a half year old was seemingly alone in the hospital room of his younger brother with no adults coming.
“Well my mommy died, but my dad is in a big-person hospital room like this one so he can’t come visit. That’s why I’m in charge. They always told me if anything ever happened to them, I was in charge of Xavier.”
“Well, you are doing an excellent job. Keep up the good work.”
I barely managed to escape the room before the tears began to flow. I went to visit my friend Wendy who worked in the adult trauma ICU. It was good to see her, but I was really there to inquire about Xavier’s dad. I got off the elevator on the 2nd floor right as the ‘Code Blue-Trauma ICU’ announcement echoed through the halls.
I follow the crowd and see Wendy elbows deep in a man’s chest. An overwhelming feeling of doom came over me that the patient was Xavier’s dad. About 40 minutes later, they stopped CPR–after all, it’s damned near impossible to do on a person with a flail chest and several other broken bones. Wendy came over, drenched in sweat.
“That sucked.” I knew the feeling all too well. We’ve been doing a lot of unsuccessful CPR in peds lately too. “His wife died yesterday–similar injuries. They were in a car crash. Drunk driver. In some ways, I think it’s good. I wouldn’t want to live knowing I killed my wife.”
“Wait, he was the one driving drunk?” I asked Wendy.
“yea, I’m just glad no one else was hurt. Amazingly the car he hit was empty.”
“Can you tell me his name? Someone else may have been in the car.”
“No, our trauma alert was for a male and female car accident victims. One male and one female.”
And I barely uttered the words aloud, ‘and our was for a 4 year old male’ when Wendy suddenly came to the realization of why I was in the adult part of the hospital “They had a kid with them!” she worked out and said probably a little too loud.
“Yea, he’s 4. Kid’s name is Xavier. He’s not in great shape right now, but you know how kids are, they bounce back pretty quick. I told his brother I’d come try to find out anything about his dad. He already knows about mom. Or at least on some level. The way he so nonchalantly said ‘my mommy’s dead’ makes me think he hasn’t processed it yet.”
“Oh that’s terrible. I don’t know how you do peds. This right here is why I stick with adults. I don’t feel sorry for him. He killed his wife and himself. I’d want to take those babies home with me and tell them they were safe.”
I went back to the 5th floor–Pedi land–we called it to distinguish it from the adult part of the hospital. I didn’t know what I was going to say to Xavier’s brother; I didn’t even know his name.
Much too frequently I get that comment “I could never do peds” comment a lot along with “I’d want to take those babies home.” I’m sure everyone who works in pediatrics has their own reasons for gravitating towards that speciality, but mine is pretty simple.; I don’t often do a good job explaining it but I want to be the adult I never had, even if it’s for a 12 hour shift. I can be the adult that reads to a kid or plays ‘basketball’ with teenage boys or paint fingernails with girls. Yes, my work is serious and they wouldn’t be here if they weren’t really sick, but having an adult treat them like a whole person is an easy thing yet so many don’t do it.
I went back to Xavier’s room. His brother had fallen asleep reading to him. I pulled a blanket up over him and took the book and put it on the bedside table. One more night of having his world intact because in the morning *someone* will have to tell him he really is in charge of Xavier because both his parents are dead.
And on my way out after my shift, I stopped by the director’s office and formally asked for a leave of absence. It was granted and I left the hospital unsure of when I might return.