COTW: 10 months old

Right around noon, a nursing student quietly walks up to me. "The child in bed 3 has changed condition." Changed condition, I have learned, is never for the better, and is almost always a dramatic understatement. Usually this means they have stopped breathing, or suddenly look like they are about to.

Within 20 seconds, the child is in a small side room, and myself and two other interns are suctioning her mouth out, bagging her, and performing chest compressions. Such events are never "routine", but since coming here, there has been ample time to develop a certain calm even in the midst of a resuscitation. "OK, guys, let's think through her case really quickly, to see if we can figure out anything that might help."

She's 10 months old. And unlike so many of the kids we see, she appears to have been healthy up until a week ago. She had been having a cough and some fever for a few days, and was seen at various health centers, getting some typical meds. She came to us the day before, in pretty decent respiratory distress, and not feeding at all. She was started on antibiotics, and IV fluids, and given oxygen.

Now she has no heart beat, and her pupils are dilated. We're suctioning milk out of her airways, and we're not sure how that got there, since she wasn't supposed to be eating, given her terrible breathing situation. The compressions and bagging continue, and after a few doses of epinephrine, we realize that nothing is bringing this kid back, and we stop. One intern goes to fill out paperwork, the other goes with me and the chaplain to talk with the stunned mom, who promptly falls to the floor, wailing and beating her fists on the concrete.

By the time everything is done, it's time to head home for lunch. It's a downhill walk, so my feet can just follow gravity, while my mind is caught up in everything that just happened.

I open the door, and Maggie looks up from her baby books. She smiles her big open-mouth, toothless smile. I snatch her up and hold her to me, even as she gently pushes me away, because she wants to get back to her books. I set her down and look at Rachel. It helps to know that she understands, since OB loses their fair share of babies as well.

10 months old. Previously healthy. Maggie is 10 months old. I have no real fears about her health, since she lives in this clean place with quick access to a hospital and practically every adult she knows is a doctor. But I just left a mom who now has no 10-month old. My hands had just been pushing on the ribcage of a girl who is now gone. And here I am, with my fingers now running through Maggie's sparse brown hair, as she babbles happily at her well-worn copy of "That's Not My Bear".

Guilt? A little, in the irrational way that all of us who mourn feel guilty that we're not the suffering ones. But the predominate feeling that such a surreal (and yet common and recurring) situation brings is that of a deep ache of beauty. Gratitude crushes me, and I know that I don't deserve the goodness that tumults over me like waves and breakers. I haven't earned this. That has always been true, and always acknowledged by my mouth, but the reality of it makes me want to gasp and smile and laugh and weep.

This is another aspect of where we live. The beauty around us here, and in the world as a whole, is positive beauty, not just the negation of ugliness and evil. But nonetheless, when it is surrounded by so much tragedy, it shines brighter by contrast. There is a mystery to it which makes me feel small, and thus it has taught me truth.

So pray for our hands and minds, that we might be able to bring as much light and life as possible. Pray for our hearts, for without Christ in them always, we would labor in vain, and that for not very long. Pray for our patients, that they would know life. But pray also for the grieving, for they are always here with us. This is a fitting aspect of the work of anyone who is seeking to follow Christ by getting their hands dirty with the needs around them.

Blessed are those who mourn, for they shall be comforted. - Jesus