No one needed me here now. No one needed this to happen.
Much of the young boy's hospital room was dressed up. Balloons offered advice to GET WELL SOON. Sun stained birthday cards hung on loose string like stretching, morning legs. One could hear the music of some nursery rhyme playing somewhere in the ward. If one didn't know any better, the room could've been mistaken for a home.
His chart said it had been a year since he visited his home. A year since he had gone outside. A year, I thought, since he had felt the wild wind and the naked sunshine and played in giving, generous waters with other children. It had been a lifetime ago.
Before tonight, I met him twice. We spoke about nothing at all. It was enough.
This was not, though. This was too much. His parents’ eyes pleaded with me as I entered the room. They sunk into my whitecoat.
“My name is Kacper Niburski, and I am the medical student with you tonight.” One of the parents made a sound like a tire sputtering on ice.
What was I doing? Why did I have to perform this ritual? The resident was doing the emergency consults, so only I was available on the wards for this terrible thing already passed. I washed my hands. He did not worry about germs anymore. I dried my hands. He did not worry if they were cold. I stepped as quietly as I could, shuffling in the dark, tiptoeing, trying to not rouse the other patients sleeping on the ward. He did not wake up.
He laid in his bed quietly. He was curled into a tight ball, into how the universe might've been at the beginning. His legs were exposed from the swallow of the blankets. They were skinny, bony things. They were good examples of anatomy.
But that nursery rhyme from the other room broke the thought. It was playing louder now. I recognized it as one from my own childhood. I could not recall the words, but I remembered rooms very much like this, very much unlike this, too.
Each blanket had to come off. I had spent much of my pediatric rotation mastering the skill of swaddling. Most of the technique was not in the folding, but rather, in the straightening. Flat ends must align with the body's own natural curves, a nurse told me during my first shift. There are ways to do everything, with only a few of them right, she added. I agreed then, as I did in this room. There are a million ways to live, but only a few to die.
Which was it? I was supposed to determine the cause of his death, to issue a death certificate after. The differential was lonely, sickening, stupid. It did not feel like medicine. It was what I was to practice, to learn how to perfect; I could no longer do harm here.
The white sheets peeled like a dry orange. One of the parents sobbed. The other, the father, looked at me struggling the way one might a dog trying to get a stick through a door. He asked if I need help. I did.
Together, the father and I carefully unwrapped him. It felt as if we were in ice, picking our way out in tired, deliberate measures. We began with his caved chest. We proceeded to his thin arms. We left his legs for last. We were slowest here, as though there might be still time to take it all back. Time to watch him read his birthday cards again. Time for him to play the game console permanently placed in his room. Time for him to not worry about time again. All we needed was a second more. Maybe morning to move into the room happily. Maybe another, different song to come play on in the ward. Anything, really, besides this. The father nearly released his end of the blanket just as we reached the big toe. I did.
I apologized to the father. To the child. To everyone and everything.
Exposed now, his small body smelt of the room, of the delicious family cooking that was brought in a week ago that was shared with the nursing staff, of the teddy bears that surrounded his bed, of the thick, tarry vomit on the floor. I guided my hands onto his wrist as I have to hundreds of patients before. I did not feel a thing. My stethoscope hung on the gaunt cliffs between his ribcages. I did not hear anything. I made my final trek to his heart, an ocean before, a total, tireless thing before. I did not note any sound. I did not.
As I arched my back up again, the nursery song in the other room felt as though it was perched on my shoulder, the radio blasting right into my ear. It was greedily noisy. It squealed. Yet it, too, was nearing its end.
I removed the soundless stethoscope from my ears. I said I am sorry once more. I said it loudly, forcefully. Full of life.
Then, after the mother wailed, after the father choked, after the moments where there should be no afters for there should be no death of a child, I turned away. I had a full night ahead on the ward still. Other patients needed me.
Published online: September 04, 2020
The author has no conflict of interests to disclose.
Copyright © 2020 by Academic Pediatric Association