A few nights ago, in the pediatric ICU, I got a glimmer of my future…

I was on call, and the critical care fellow asked me if I was interested in taking the next admission, a transport coming in from a community hospital. I wasn’t terribly busy, so I grabbed the intake form to read a little bit about the patient, and what little there was did not sound good. We were expecting a nearly two-year-old girl who had had a few episodes of vomiting two nights prior, then developed a low-grade fever, and was ultimately found to have a moderately-sized abdominal mass; she was actually from Atlanta, and had just been visiting family up in New Jersey. The toddler was being brought to our ICU because the small workup that had been done at the community hospital pointed in one clear direction: she would need to have some combination of surgery, chemotherapy, and radiation, and she would need it soon.

During the entire time I spent with the family, I was able to watch their fighting instincts as they rallied. Their little girl was overwhelmed — her belly hurt, she was lying in a cold room in a totally foreign place, there were half a dozen people poking and prodding at her, and as all kids can do, she sensed the urgency and fear on everyone’s faces. As a result, her parents began to focus on anything over which they still had even a modicum of control — giving her sips of water, patting her hair into place, making sure her favorite slippers were snugly on her feet. While our focus as physicians was on things like the nuances of her presentation and the ultimate diagnosis, their focus as parents was on the few hours between then and when she would go to the operating room, and figuring out how they could cross that chasm of time without declaring to the world how overwhelming everything had quickly become. They did a great job, but it was obvious that it was taking every morsel of energy they could muster.

Somewhere in the middle of the night, it hit me that next July will bring an abrupt shift in my life wherein experiences like this will become the norm, rather than the exception. Now, as a resident, I don’t see many initial cancer diagnoses; as a fellow, I’ll be the one who almost exclusively sees them, and who gets to be involved in guiding families to a place where they can help their children come out healthy on the other side. Some parents will be able to handle that first night well, others will lose any semblance of control, and still others will find that they cannot even wrap their minds around the magnitude of the situation. This is all to say that there will, undoubtedly, be some rough times, but there will also be many exhilarating times, and I have come to understand that the latter make the former bearable for me.

A few nights ago, in the pediatric ICU, I got a glimmer of my future… and sincerely liked what I saw.