(image courtesy of my friend KHW with serious photo talent who chronicles life in NYC very nicely)

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New York City had its first snowfall last weekend.

That Sunday morning I walked out of my building and looked across the street at the divinely snow-covered Central Park.  I am still savoring that moment - it was beautiful!  We were off to our ‘Sunday-before-Christmas’ church services for which both the mister and I were to address the congregation.  These are the thoughts that I shared on the works of Christ.

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(the following account has been shared by me before)
I’ve never forgotten the deaths of the children I’ve witnessed during medical training.

Sometimes I was right next to the child as part of the resuscitation efforts, other times I stood afar hoping to help in some small way.

But there is one family that I think about more often than the others…When I arrived at the patient’s room two ICU Attendings were already present with other residents.  As usual, the crowding around the bed only frustrated an already intense situation.  After helping draw up rounds of Epinephrine I realized I was probably more of a hindrance given the large number of medical providers.  As I withdrew, my eyes surveyed the other rooms.  I noticed the child’s mother sitting in a chair against the wall in another room.  I will never be able to describe the look on her face.

I walked into the room and held her hand.

‘I do not know English very well’

‘That’s ok. I’ll be here for you’

Because of the unique language she spoke, there was not an available patient support representative as would have been most appropriate.  I immediately called our language center and was connected to an interpreter.  From our 3-way conversation - myself with the child’s mother on one end, and the interpreter on the other - I learned that the father could not take a taxi because they did not have the money.  She had immediately called him when the resuscitation efforts began.  He was en route to the hospital but would not be reachable for another 20 minutes while underground in the subway.  At that point, she had only communicated to him that their child was not waking up.

We sat in silence for what seemed like an eternity.  It may have only been a few minutes - I’m not sure how long the actual resuscitation efforts took place - but I’m confident everything that could have been done for the child was done.  So when one of the ICU Attendings came into the room - I knew by the look in her eyes that it was very bad news.  I explained where the father was and what the mother understood…all the while, the interpreter was on the phone waiting.

The ICU Attending looked at me and drew in a deep breath.  She spoke into the phone in the most gentle manner, “I’m going to ask you to do something very difficult.  I need you to say exactly what I say.”  The interpreter agreed.  Over the phone in her native language, this beautiful Mother learned of her child’s death.

‘I’m so sorry.  We did everything we could.  We could not save your child.’

Her hand clung to mine as she crumpled from the chair to the floor.

In Luke Chapter 8 we read the following account:

‘And, behold, there came a man named Jairus, and he was a ruler of the synagogue: and he fell down at Jesus’ feet, and besought him that he would come into his house: For he had one only daughter, about twelve years of age, and she lay a dying.  And when he came into the house, he suffered no man to go in, save Peter, and James, and John, and the father and the mother of the maiden.  And all wept, and bewailed her: but he said, Weep not; she is not dead, but sleepeth.  And they laughed him to scorn, knowing that she was dead.  And he put them all out, and took her by the hand, and called, saying, Maid, arise.  And her spirit came again, and she arose straightway: and he commanded to give her meat.  And her parents were astonished…’

Charles Dickens reflects

“Oh what a sight it must have been to see her parents clasp her in their arms, and kiss her, and thank God, and Jesus Christ his son, for such great Mercy!”

Of all the myriad works of Christ - from changing water to wine, teaching learned men, to feeding 5000 with just a few loaves of bread and a couple of fish - my thoughts turn to the latter part of Mosiah 3:5 in the Book of Mormon.

“For behold, the time cometh, and is not far distant, that with power, the Lord Omnipotent who reigneth, who was, and is from all eternity to all eternity, shall come down from heaven among the children of men, and shall dwell in a tabernacle of clay, and shall go forth amongst men, working mighty miracles, such as healing the sick, raising the dead, causing the lame to walk, the blind to receive their sight, and the deaf to hear, and curing all manner of diseases.”

As a medical provider,  I’ve experienced a fair share of medical triumphs…but the lives that weren’t physically made whole are the ones that linger in my mind; the inebriated college student who fell and smoldered in a fire pit - he was unconscious in the burn unit for weeks;  the 850pound plus woman with an infection of her fat; the micro-preemies in the NICU, the boy with AIDS who had severe diarrhea - the only thing I could do was hold his hand…the children who died; and that mother who lost her child.  Despite all our medical advances, they were not healed.  Their lives reinforce my testimony that Christ is ultimately the healer, the only Physician.  We know his greatest work was made on our behalf - Redemption through the Atonement.

Elder Holland teaches us
‘Jesus taught the Nephites, who lived in a world at least as difficult as our own, “For the mountains shall depart and the hills be removed, but my kindness shall not depart from thee, neither shall the covenant of my peace be removed [from thee]” (3 Ne. 22:10). I love that. The hills and mountains may disappear. The least likely things in the world may happen, but his kindness and peace will not be withdrawn from us. After all, he has, he reminds us, “graven thee upon the palms of my hands” (1 Ne. 21:16).

In the example of the Savior himself and his call to his Apostles, and with the need for peace and comfort ringing in our ears, I ask you to be a healer, be a helper, join in the work of Christ in lifting burdens, in making the load lighter, in making things better.’

***

Christmas time in New York City is incredible.

I love this city because of the diversity of religion and people.

I wish you and your family the best during this holiday season.

My older brother is now a third year medical student, and this past summer as he studied and crammed for Step 1 of the boards and felt so much pressure, I tried to calm him down and talk him through the psychology of the big tests.  He had built it up to be the biggest, almost unconquerable set of questions and was so worried about getting a good score.  I did agree with him, because the test is hard in all the minute details is tests- the enzymes of the krebs cycle, the endless neuropathways, etc.  But I tried to tell him that you have to calm down about it, because boards just become a way of life. There is always a boards or a recertification looming.  He didn’t believe me, he knew that conquering step 1 was the main goal.

Then he said something hilarious, that I will always remember.  Having just finished 2nd year med school, with a determination to get a good score on step 1 of the boards he said, “I just have to do this, and then all of this with be half over.”  I chuckled, and have chuckled many times over, because there I sat- 10 years since starting medical school, step 1, 2, 3, and peds boards behind me, and the peds ID boards looming, then peds boards recert a few years after that, and I was pretty sure that the halfway point wasn’t getting through step 1.

But in my brother’s defense, there is no way to know what is ahead of you until you make your own way and live it yourself.  It has made me reflect on my own medical training.  What was the hardest part for you?  What was most physically demanding?  What was most mentally taxing?

I loved medical school.  Sure it was hard, but I loved the classes, then loved rotations.  Except for psych- finding myself in the ER at 3 am with a schizophrenic who thought she was Abraham Lincoln is only entertaining now in dinner conversation.  Residency was great- hard when it was supposed to be hard, intellectually stimulating, great cases, amazing clinic mentors, such fun people to work with, and nurses with great NYC attitude to keep me laughing on the inside.  It also helps that I fell in love and got married during residency.  That casts a nice pink rosy glow over those years.

Then comes fellowship.  Undeniably, the first year of fellowship was the hardest year of my training. Great cases, learned all I should ever hope to learn about ID in the crazy immunocompromised, crazy traveler, and every once in awhile-ID in a normal kid.  But my program has one fellow a year and you do all clinical service all year long with breaks few and far between.  I remember when I was on my 11th week of straight 24/7 service and I thought I was going to die.  Always getting paged through the night by a pmd or er doc 100’s of miles away wanting me to manage a kid via the phone.  Then 14-16 hour days every day with constant paging, rounding, new consults, outside physicians calling for curbsides.  Yikes. It wore me down week by week until I had nothing left at all.  The other fellows in my program all agree, it takes a couple months after finishing that first year to let all the insanity start to fade.  But it did start to fade.  I finished my fantastic and interesting research projects, have a couple of publications under my belt, have a wonderful real grown up job, and now once I finish these peds ID boards, then all of this will be over?!?

Dr. C