“I want to start with a new patient we had flown in during the night. She was diagnosed at three days old with hypoplastic left heart syndrome after she became cyanotic. We have the results of the echocardiogram that was performed. It looks like the IV medications are working for now, but I want to see her first and have a talk with her parents,” Sarah said as David joined her on her rounds through the unit.
“I’m glad they caught it this early. I’ve seen cases where it’s only been diagnosed after the infant is critical and unstable,” David said as they stopped at the door of a room where a young mother stood over a sleeping infant.
As they entered the room she saw a young man asleep on a cot that had been brought into the room as well, leaving her in no doubt that it had been a long night for this young family.
“Ms. Lawrence?” she asked as she held out her hand to the young woman. Her eyes were red and damp and Sarah’s heart broke for the woman. She would never be able to forget the helplessness you felt as a mother unable to make your child whole again.
“My name is Sarah and I’m a nurse practitioner with the thoracic-cardio group, and this is Dr. Wright.”
She watched as David shook the woman’s hand and then led her to a group of chairs in the room.
“Shall we sit down?” he asked the young woman who looked close to collapsing.
“Let me wake my husband,” the young mother said. “And please call me Maggie.”
The young mother bent over and whispered into her husband’s ear. When the couple joined them, Sarah began going over the tests that had been done on their daughter so far. Though she was sure the doctors had reviewed everything with them before their daughter had been transferred, Sarah knew that it was easy in these situations for parents to be overwhelmed with too much information. It was better to repeat the information they needed than to assume they had been informed.
“So, the IV medications that they’ve started Breanna on are working?” John, the young father, asked, looking hopefully across the room where his newborn daughter lay.
“For now, but it’s only a temporary fix. Breanna still needs surgery and there will be more surgeries necessary later,” David said.
As David went on to explain the procedures that were needed and the many surgeries that would be necessary, Sarah found herself impressed with how understanding and patient he seemed to be with the parents’ questions and concerns.
Before they left the room, Sarah listened to the baby’s heart and lungs, noting that even with the medications that were keeping the ductus open, the infant’s color was still a sickly gray. She pulled out her phone and texted the cardiologist on call with her concerns, then used the computer at the bedside to order the tests that would be needed before they took the infant to surgery.
“I’m sorry. I haven’t been officially assigned to the case, I shouldn’t have taken over like that. I get a little carried away sometimes. It’s just...” said David. “It’s better that they know what they’re up against from the beginning so that they can prepare themselves.”
“We have a great team here and we stress the importance of making sure all our parents understand what is going on with their child, but sometimes they’re in such denial that it just takes time for them to come to terms with their child’s condition,” she said. Sarah understood his frustration only too well. She remembered being on the other side of those conversations when her mind had been unable to wrap itself around what she was being told by the medical staff.
She forced the thoughts of those days away, and mentally shut the door to where she kept the memories of a life she’d had before locked away. There was only one place where she felt safe to take those memories out and it certainly wasn’t here at the hospital. She’d always been very careful to keep her work life separate from the personal memories she had of this place.
“There’s nothing that can prepare them for how their life is going to change. Right now it looks like they have a strong marriage. We can only hope that it will be up to the test that having a critically ill child brings,” David said as they headed toward the next room.
Was that a hint of bitterness that Sarah heard? There was a story there, she was sure. Glancing over at David, she tried to catch a glimpse of the man she had seen earlier, the man with the haunted eyes. It seemed she wasn’t the only one who had something she kept hidden away.
They made their way through the critical care unit and then continued down the acute pediatric cardiac floor, looking in on patients recovering from surgery and those who had been brought in for assessments for surgery or for placement on the transplant waiting list. They stopped at the room of a teenage boy, Jason, who had been brought in after collapsing on the baseball field at his high school a couple of days ago.
Sarah had tried to get the boy to talk to her on her last two visits, but he’d answered her with only one word responses then focused on his phone when she had tried to start a conversation with him.
“Jason’s scheduled tomorrow to have a defibrillator implanted, but he’s refused to agree to the procedure,” she told David as they stopped outside the room.
“I know it would be best to have his agreement, but the fact is that he’s a minor so we only need his parents’ consent,” David said.
“Well, yes, but that’s not the point. He’s the one who’s going to be living
