When a Child is Critically Ill

by Carole G. Vogel

Originally published: Cell 2 Soul. 2006 Summer; 2(2):a8

One morning, as I was drinking my coffee and perusing the newspaper, Katy peered over my shoulder. I was turning past the obituaries and something caught her eye.

“What are death notices, Mommy?” she asked.

“Information about people who recently died.”

“Do we know anybody in them?”

“No,” I said with certainty, and then the name of my physician’s daughter seemed to leap right off the page. As I read in horror, I remembered the picture of a beautiful child that graced my physician’s office. I recalled the stories her proud father had shared with me over the years while he checked for pneumonia, ulcers, and strep. Cancer had put a swift end to the little girl’s life, and I began to weep because my greatest fear had become my doctor’s reality.

At the funeral, the rabbi paid tribute to a child with a sun-shiny disposition and an uncanny ability to see only the good in people. He described a little girl so much like Katy that for a fleeting instant I felt as though I was attending my own daughter’s funeral.

One year later, I found myself sitting next to Katy’s hospital bed and the memory of the funeral came back to haunt. It was 2:30 in the morning and Katy lay weak and pale with IV tubes protruding from her arm.

We were not supposed to be there, my daughter and I. She was supposed to be safe at home, asleep in her own bed in the room next to Joshua’s, and I was supposed to be in the same house nestled close to Mark.

A few months earlier, Katy had noticed a bubble developing in the tissue beneath her tongue. “Mommy, it doesn’t hurt,” she said, “but it makes me talk funny and I can’t take big bites of food.”

A trip to the oral surgeon confirmed that she had a blocked salivary duct. Trapped saliva had collected and formed the bubble. In a simple office procedure, the surgeon tried to remove the blockage. Six weeks later, the bubble returned. The surgeon repeated the procedure and again the bubble reappeared. We were debating the next course of action when one evening Katy dashed from the dining room table into the bathroom. She emerged two minutes later, crying.

“My bubble burst!”

“It broke once before,” Mark reminded her, “and the surgeon told us that was normal for a bubble. You have an appointment with the surgeon next week and you can tell him about your bubble then.” His words soothed Katy

That night, however, she woke up screaming — her throat hurt. I comforted her and made a mental note to call the doctor in the morning.

“Katy’s timing couldn’t be worse,” I moaned to Mark over breakfast. “Sunday of Presidents’ Day Weekend.”

We belong to an HMO, which is supposed to provide 24-hour coverage. However, we couldn’t reach our oral surgeon and were told mistakenly that we couldn’t see any oral surgeon until Tuesday. We were then directed to bring Katy into the clinic to consult with the pediatrician on-call.

“I’ve never seen a blocked salivary duct,” confessed the pediatrician, “but Katy appears to have a strep throat and penicillin should cure that.”

Back home again, I medicated Katy and put her to bed. She slept through the afternoon and when she awoke the left side of her face and neck were badly swollen and distorted. The soft tissues on the floor of her mouth had enlarged so much she could not put her teeth together. Mark and I knew something was terribly wrong.

We called our HMO and spoke with a different pediatrician. He connected us with an oral surgeon, not our own, who told us to bring Katy to the hospital immediately.

The oral surgeon met us in the emergency room. After examining Katy, he confirmed our suspicions that the salivary gland had become badly infected.

“I’m worried,” he said, “that the infection may cause cellulitis, a condition where the tissues of the throat become so hard and enlarged that breathing can be blocked.”

He never used the term “life-threatening” but from his actions and tone of voice, even Katy knew it was.

“Mommy, is this serious?” she asked in her I-want-to know-the-truth-voice.

I took a deep breath and tried to keep my anxiety from showing. “Yes, it is.”

“Is it very serious?”

“Yes.”

Katy didn’t want to know more. She turned her face to the wall.

The doctor hooked Katy to an IV and penicillin began to drip slowly into her veins. An orderly wheeled her to a bed in the pediatric ward and we sat with her into the evening and tried to buoy her spirit.

“Why don’t I spend the night with Katy while you take care of Joshua at home?” I suggested to Mark at ten o’clock. “Then you can relieve me in the morning. I promise to call if Katy’s condition changes.”

Mark reluctantly agreed. Shortly after he left, a pediatric surgeon came and introduced himself to Katy.

“Why are you here?” she asked.

“Just in case you have to see me later tonight, I don’t want you to be afraid of me,” he replied.

His statement reassured Katy but chilled me.

He then ordered the nurse to hook up Katy to a heart and respiratory monitor. Out of ear shot of my daughter he explained that if Katy and I both fell asleep and her breathing stopped, the monitor would alert the nurses.

His words guaranteed a sleepless night for me. I could not entrust my daughter’s life to mere machinery. As the hours passed, I sat and watched the drops of medicine glide down the IV and into Katy’s body. The cliche miracles of modern medicine took on new meaning, and I thought about the women in my family who had come long before me and the children they had lost to infections.

On an outing, my great-grandmother’s brother had quenched his thirst with well water not realizing it teemed with typhoid fever germs. He suffered a slow painful death. His sister told me how their mother sat with him, grief-stricken and powerless, watching him slip away.

I felt connected to this mother and to all the other mothers who had sat and watched and waited as their children struggled in their fight for life. Knowing I live in the age of antibiotics provided some comfort but did not erase the fear that I, too, could lose my child. Children are not supposed to die before their parents, yet some still do. What, I wondered, would I do without my daughter?

I focused my attention on Katy and watched her chest rise and fall in the peaceful rhythm of deep sleep. I felt grateful for every breath she took.

By the next day, the doctors pronounced her out of danger. A few days later Mark and I brought her home. A month passed and Katy returned to the hospital for surgery — the offending gland was removed and her recovery was swift. Katy returned to her bouncy, happy-go-lucky self once more.

I, on the other hand, lost my sense of safety. Now, more than 15 years later, it has long been replaced with the appreciation that time spent with Katy, Joshua, and Mark, is a gift to be savored and never taken for granted.