She finished the letter and signed it, With all the love in the world, Mom.
I was helping my mother string lights on the shrubs outside our home the winter before she got sick when she first told me about the miracles of Christmas. “Jesus was born at Christmas,” she said, wrapping a long strand around a juniper yew. “He left Heaven to live here.” She bent over the back of the yew and tugged at the lights, stuck on a low branch. I pulled along with her, and together we continued wrapping the bush. “That’s kind of like us becoming a worm and living in the dirt,” she said, wiping her nose. “Love came down on Christmas, Nathan. That’s the greatest miracle of all. That’s the true blessing of Christmas and why it will always be the season for miracles.” She stood back and admired her work, frowning at the tangled mess. “It’ll look better when the lights are on.” She dug into the box and pulled out another jumbled string, talking as she worked. “If you get too busy, you won’t see the miracles that are taking place right in front of you,” she said, replacing a blown light.
Before she died, my mother bought special gifts for Rachel and me; she wanted my father to give them to us on our sixteenth birthdays. Rachel got a gold locket and I got this watch—a flat, gold-faced Timex with a simple black band. The inscription was a reminder of something I’d always asked her.
“Is your love for me as big as Texas?”
“Bigger,” she’d say.
“As big as the United States?”
“Bigger.”
“As big as the world?”
“It’s even bigger than the world! But if you combined all the love in the world, it might come close to how much I love you,” my mother told me.
I’d worn the watch every day since my father gave it to me, as promised, on my sixteenth birthday.
Soon after my mother’s death I told my father and grandmother that I wanted to be a doctor. When people asked what I wanted to be when I grew up I responded the same. I wanted to be a doctor so I could help people just like my mother.
Before I knew it, I was through college and into medical school. What a tribute to your mother’s memory, an aunt would say or, What a tremendous way to honor your mother, an old family friend would comment. I felt the pressure mounting—people were counting on me to become a physician—my mother’s memory depended on it. But after three months of rotations and watching people suffer and die, and now a week with Dr. Goetz, I questioned whether I’d made the right decision. In all honesty, when someone died it left me emotionally drained, and I was taken back to the morning my mother passed away. I felt as if I didn’t measure up, that I wasn’t cut out for it. I opened my eyes and realized I needed to get back to rounds.
Our team gathered outside the patient’s room, and Micah, another third-year med student on our team, stepped forward and began to give the patient’s blood pressure, pulse, heart rate, and the results of a heart test administered the previous afternoon. Micah was the “gunner” of our group—a med student’s term to describe a fellow student who was always the first to answer, the first to volunteer for a procedure, the first to give stats on someone else’s patient, and the first to get on other students’ nerves. The term had been around long before we ever applied to medical school. William and I shot each other glances as Micah handed out Xeroxed copies of an article on angioplasty from one of our textbooks, one of at least twelve articles so far, all of them filed after our rounds in the nearest garbage can. William and I suffered in silence; it was all we could do, there was a gunner on every rotation.
Helen Weyman was the next patient on our rounds. She was a fifty-two-year-old woman complaining of chest pain who had a history of cervical disc disease. I had done Helen’s workup when she was admitted to the hospital the previous afternoon. I went over her progress notes with the team before entering her room. It was customary that the attending physician took over once the group entered the patient’s room; it was our time to stand back and learn, but I felt it was important to greet my patients first.
“Good morning, Helen,” I said, standing at her side. “I see your daughter was able to bring your knitting to you. Now you’re not so bored, I hope.” Dr. Goetz glanced at me. “What are you making?” I asked.
“A baby blanket for my next grandchild . . . number three. I’ve made a blanket for all of them. She’s due in the next week or two.”
I picked up the blanket and turned it over in my hands. “You’ve even got her name in here!” I sensed Dr. Goetz waiting for me to finish. “Let’s go ahead and take a listen to your heart again this morning.” I listened to her heart and felt for her pulse. I was taking up too much time. “Dr. Goetz would like to listen to your heart today as well.” I moved away from the bed. Dr. Goetz took my place and examined her. As he did, he asked her about all her grandchildren, where they lived, how long she’d been married, and if she’d make him a pair of slippers. She laughed, and I watched as Dr. Goetz won over yet another patient. Before leaving the room I squeezed Helen’s shoulder and told her I’d be by later to check on her.
I walked with William toward the cafeteria for lunch when my pager went off. I walked to Helen’s room. The baby blanket was still sitting on her lap. Her daughter Mary, looking very pregnant and uncomfortable, was sitting in the chair next to the bed. “Is everything all right, Helen?” I asked.
She leaned forward and rubbed her hand over her lower back. “My back has been hurting.”
I helped Helen into a more comfortable position. “You’ve been immobile longer than usual, and that may be putting pressure on those discs in your back. Does that feel better?”
She paused for a moment. “Yes, thank you, I think it helped.”
“So you don’t think it’s anything serious?” Mary asked.
“No, it may be just some inflammation around those discs. But we should rule out any other possibilities,” I said, handing the knitting back to Helen. “How much longer before this is done?”
“Just a couple more days, I think,” she said, taking the needles in her hand.
I left her room and went to the nurses’ station to discuss follow-up with the nurse on duty and to page one of the residents when Mary came rushing from her mother’s room.
“My mother needs help!”
A nurse ran past me and headed to Helen’s room. I followed close behind. I had just stepped inside when the nurse called in a loud, firm voice.
“Page, Dr. Vashti.”
I stood in the hallway, right outside Helen’s door, feeling helpless as Peter wheeled Helen to the OR. I was ordered to stay behind and attend to the other patients on the floor.
I finished my duties and ran up the two flights of stairs to the OR. As I threw open the door, I saw Peter waiting for the elevator.
“What happened? How’s Helen Weyman?” I asked.
“She died a few minutes ago,” Peter said.
It couldn’t be possible. Helen was knitting a few minutes ago.
“What happened?”
“She died from ascending aortic dissection,” Peter said.
The elevator doors opened in front of us, but I couldn’t step forward; my legs were too weak to carry me. Peter stepped inside the elevator and held the door open for me. “Nathan?” I looked at him but couldn’t respond. My mind was racing. If Helen died of ascending aortic dissection, it meant the pain she felt in her back was caused from a tear in the aorta, not her cervical disc problem.
“She told me her back was aching. I thought that the pain was attributed to cervical disc disease. I had just gone to the nurses’ station to—” Peter nodded, cutting me off.
“Given her history, I would have thought the same,” he said. I stepped inside the elevator and watched the doors close. The elevator stopped, and I followed Peter into the halls of the cardiology department. “Helen was a woman with a long history of back problems, Nathan. She was much sicker than any of us knew, and sometimes there’s just nothing we can do. This is one of those times.”
I walked past th
e room where Helen had stayed, and a nurse was clearing away Helen’s personal items. I leaned against the wall outside the door. It felt hard to catch my breath. I bent over, resting my hands on my knees. My mind drifted to my very first rotation. During that two-week surgery rotation, a twenty-seven-year-old was brought in after a car accident. His arm had been lacerated in the crash, nearly severing it. In an effort to save the arm and avoid any further nerve damage, the patient was rushed to surgery.
The surgery was proceeding well, until twenty-two minutes into it, the patient’s heart went into failure and he died. It was the first death I had encountered, and it hit me harder than I’d imagined; intellectually I knew it came with the territory, but my heart wasn’t prepared. My heart was with the family when they received the unexpected news; it was there as the phone call was made to the funeral home for final arrangements.
I stood in the operating room after the monitors were turned off and stared at the man’s face, his hands, and his clothing. When he woke up that morning he had no idea that the jeans and pullover shirt he wore would be the last clothes he’d ever pick out; he had no idea it would be the last car ride he would ever take. I wondered what his last words were to his wife or what he had said to his mother or to his children. Did he have children? Even after the curtain was pulled around his body, I went back in and looked at him. It was hard to sleep for days. To make matters worse, I didn’t see any of the other students suffering in the ways I did.
After Helen died, I confided my doubts to William during a game of one-on-one basketball.
“It’s because our hours are so long,” William said. “We’ve been thrown into the deep end, and we’re going to sink or swim now. You’d see things differently if you just weren’t so tired.” He sank a shot over my head. I grabbed the ball and held him off with one arm. “You’re taking Goetz too personally. He comes down hard on everybody.” I ran around him and jumped in the air, aiming for the basket. The ball dropped through the hoop and William grabbed it, dribbling it close to the floor.
“It’s not Goetz,” I said, lunging for the ball. “A patient died under my care.”
“She wasn’t under your care. You were the med student on the team that was treating her,” William said. He rested the ball on his hip, wiping his face with the back of his arm. “There was nothing anyone could have done. You need to stop blaming yourself.” He was moving again. I charged for the ball and snatched it away from him, throwing in a sweet two-pointer. He caught the ball when it fell through the net and darted past me, up the middle.
“She trusted me, William.” I wanted to tell him that somehow I felt responsible for Helen’s death, but I didn’t know how to say it.
“Did you go into medicine thinking you could save everyone? If you did, you’re going to burn out faster than any of us. What’s important is that your patients feel safe with you. You’re good with them. You know how to talk to them. Helen Weyman never thought for a second that she shouldn’t trust you.”
I wanted to jump in, and say, “Exactly! She felt she should trust me—that somehow I was going to help her but I couldn’t.”
“I don’t think my patients like me,” William said, moving past me, dunking another ball. I grabbed it and held him at arm’s length.
“They’re just afraid of you,” I said, spinning on my heels. “You walk into their room, and they’ve never seen anybody as big as you. They’re not sure if you’re there to work ’em up or rough ’em up. You’re an imposing black figure when you walk into a patient’s room.” I darted past him and jumped in the air. The ball swiped the bottom of the net and I groaned. William was ahead. He laughed and snatched the ball, dribbling it close to his body.
“You mean I’m like Shaft,” he said, holding me away.
“You’re badder than Shaft. You can insert a catheter.” He laughed and tried to run around me. “Do you ever have doubts?” I asked, waving my arms in his face.
“Sure I do.” He sank another shot over my head. I didn’t believe him. But he was right about one thing: our hours were brutal, the work was intense, and together they left me physically and emotionally exhausted. Now Dr. Goetz seemed determined to turn my rotation into the most miserable experience of my education. If I was going to start swimming, I had to get out of the deep end of the pool with Dr. Goetz before he drowned me.
Sleep never came that night. I looked at the clock at 10:30, 11:45, 1:20, 3:00, and then again at 4:45 A.M., when I finally decided to get out of bed. I stood in the shower for thirty minutes, hoping that the water would wash away Helen’s memory, but every time I saw her face, I saw my mother’s, and I just didn’t think I could go through that over and over again.
Meghan Sullivan poked her head inside the hospital room of twelve-year-old Charlie Bennett. When the college freshman saw that the boy was awake, she ran to his bed and plopped down on top of it. “I looked all over for you after the meet. Your dad found me and said you were here. What’s going on?”
“Ask Mom,” Charlie said, eyeballing his mother. “She’s the one who made me come.” Leslie Bennett smiled as she stood to leave the room.
“He had trouble catching his breath, Meghan.”
“It didn’t even last that long,” Charlie said, rolling his eyes.
“Only long enough to cut a few years off my life, that’s all,” Leslie said, smiling. She grabbed her empty coffee cup off the table by Charlie’s bed and left the room.
“How do you feel?” Meghan asked.
“I feel great. I didn’t need to come in.”
When Charlie was born, only one ventricle of his heart worked. He had three surgeries during the first three years of his life so the blood flow into his heart could be rerouted, flowing to the lungs without the aid of the other ventricle. The surgeries worked, meaning that the one strong ventricle supplied blood flow to his body and allowed Charlie to live a life like other little boys his age. He rested when he got tired, but nothing slowed Charlie down for long. He looked like every other child on the playground and preferred it that way.
It was only in the last five months that he’d begun to have any sort of trouble. “How’d you do today?” Charlie asked, sitting up in the bed.
“I came in first,” Meghan said.
Charlie pumped his arm up and down with the enthusiasm of a coach standing on the sidelines of the Olympics. “What’d you run it in?”
Meghan looked down and smiled. “Fifteen-thirty.”
The boy’s eyes lit up, and he cracked his knuckles. “Man, I wish I could have been there! When’s your next race?”
“Friday.”
“Good,” he said, giving her a serious look. “Cut two seconds off.”
“What? Two seconds? Are you crazy? I already cut my old time. I ran the fastest I ever have today.”
Charlie brought his hands up under his chin and smiled. “Run faster.”
Meghan sighed. Charlie cracked his knuckles again and pointed his finger. “Don’t ever take your eyes off the finish line. If you take your eyes off the goal, you’ll never make it to the end.”
Meghan said the words along with him. “Never take your eyes off the goal! I know,” she said, shaking her head. “You tell me the exact same thing every time.”
Charlie turned into the stern taskmaster again. “Remember: two seconds.” Meghan stood and kissed Charlie’s face. He quickly wiped it off.
“Are you going to be there,” she asked, “or will you still be in here?”
“I’ll be there,” he said. “There’s no way I’m staying in here.”
Meghan had met Charlie her sophomore year in high school. Fascinated with runners he watched on TV in the Olympics, Charlie begged his mom to take him to the local cross-country and track meets. To Leslie’s embarrassment, the little boy would run alongside the runners, barking at them to run faster or keep their eyes on the finish line. He was quick to notice Meghan’s ability. “You’re the fastest girl I’ve ever seen,” he said after one meet. At each ra
ce, Meghan started looking for the little boy in the stands. She introduced Charlie and Leslie to her family, and the two families had been sitting together ever since.
Meghan slung her bag over her shoulder and headed to the nurses’ station, setting a clipboard on top of it. “Denise, would you mind if I left my sponsor sheet here so you could ask any of the doctors and nurses that I normally don’t see if they’d like to sign up?”
Denise smiled and took the paper from her. She was well aware of what Meghan was doing; her name was already one of the first on the sheet. Meghan was organizing a run that would raise money for a pediatric heart patient fund. The money would go into a trust and be awarded each year to a pediatric heart patient as part of a college scholarship once the patient had been accepted to a college. “If they don’t sign up, I’ll inject them with some sort of sponsor-sheet injection drug we must have around here someplace,” Denise said, looking in the drawers.
I walked toward the nurses’ station and was looking over the notes on my clipboard when a young woman ran into me, knocking it out of my hands.
“I’m so sorry,” she said, swooping the clipboard up before I could get to it. She laughed, and her blue eyes sparkled. Her light brown hair fell just on top of her shoulders, and when she smiled, her face lit up. She was lovely.
“No, no. It’s my fault,” I said. “I shouldn’t have been walking on the side of the hall that’s clearly designated for running.” She laughed harder, handing me the clipboard.
“Just keep that in mind from now on,” she said, smiling, jogging toward the elevator.
I set my clipboard down on the nurses’ station and rubbed my eyes. I could feel the pressure building in my forehead.
“Another rough morning with Dr. Goetz?” Denise asked. I groaned and peeked at her through my fingers. “He’s the best there is. Really.”
The Christmas Blessing Page 2
