"Where's my CAP, Millie." or Lorane, RN (Part II)

We were being thrown to the 'lions' you may recall (although I dare say our representative Millie, here - even yellowed with age - has something of a ;kitten quality; about her). And 'Red Riding Hood' was straightening her cap and some things out. I barely heard Clara's droning account of the night shift so RIVETED was my focus on the room. There were monitors, respirators, tubes, tubes, tubes. They sprang from noses, curled out of urethras, burst from chest walls, drifted into veins and out of arteries. Seven lives were "in here." Eight, counting me. Clara exited, on, "No aide today, sweetie."

I made solo, solemn bedside chart-rounds. Four of the five UNCONSCIOUS patients had been in this "unit" for months, monitored and maintained after sustaining irreversible brain damage. Leaning over the first of them, I took Mr. Goldberg's cold hand into mine and whispered dire ctly into his ear. "I'm Miss Clarke. I'll be taking care of you today (and who will take care of ME tomorrow?) and make you as comfortable as possible. This litany was repeated with the other three, while checking the artificially regular heart and breathing rates keeping time in their waltzing chests. Pupils stolidly fixed, finally dilated. That they could not respond was obvious. But I believed they could perceive. No one had proven otherwise.

Next up (or not), Frank Ryan. "Mr. Ryan, you were sleeping when I came in. I'm Miss Clarke." He looked like Stan Laurel, frail body resting on a Stryker Frame - special bed; rotated 180 degrees so you could flip the paralyzed body, sandwiched between two stretchers, then remove the top one from the back once landing-on-the-abdomen was safely completed. Frank's buttocks were now two gangrenous cavities - testimony to a time when he was NOT being turned. I assured him his dressing change/wound treatment would be the FIRST thing I did after completing 'rounds'. From his gaunt, stubbled face, his eyes shined. "Miss Clarke, I'm 'Frank'."

"Frank it is. would you like to stay on your back for a while this morning, look around?"

"Oh, how nice. . . .if you have the time," he added apologetically.

Joe Kazinski was next to Frank. No tubes. No machines. Just smiling at me from under his sheet - which was tied to the bed at all four corners. A broad forehead and black, handlebar mustache made his dark, good looks seem aristocratic.

"Clarke, " he said. "Nursie Clarke." Then as if to introduce himselt, he said, "I'm FINE!" And he winked. Skimming his admit notes, I learned he was initially treated for a concussion - subsequent to a fall. Currently, his diagnosis was "Rule out Organic Brain Syndrome." Apparently, he'd remained confused, disoriented LONG after his injuries healed. This "chronic" degenerative brain disease was being entertained. There were orders for restraints and sedation but he demonstrated no need for "critical" care, as I understood the term.

"Mr. Kazinski, have you been in the hospitalk. . ."

"Joe. Call me Joe. Or Zhivago. The supervisor calls me DOCtor."

"Joe, who is the President of the United States?" He lifted his head and squinted around the room.

"He's not in HERE. Nope. You must've missed him."

"I'll help you with your tray when it comes up, Joe."

"NEver eat before a game. But I'll be glad to help you." He was taking orders, now. "What'll it be? Just juice and coffee? We got HOT danish, today, boys."

Turning to check on the newest admission, I noticed the policeman, sprawled on a low lounge chair wedged between the bed and the wall. Arms folded across his dark blue, wrinkled uniform, hat covering his face, with head back, he slept. I thought "How did I miss THIS?" The patient's chart had a pink sticker on the front announcing, "Twenty-four-hour surveillance - N.Y.P.D" Above it, his ID: Warburton, Michael; Age: 18; Dx: Multiple Trauma/Cerebral Hemorrhage. As with his fellow unconscious patients, Michael was only alive because of the respirator. However, in this case, the admitting doctor's notes indicated his losses were "temporary."

A long, muscular youth, his body was curled into a fetal position. Head shaved, a small dressing denoted the point at which the surgeon had drilled into his skull to stop the bleeding. His bruised, swollen face was contorted, set in a grimace - one that reflected the grotesque images of the cold nightmare he was enduring, of the scenes. . . . and the I realized I was just STANDING THERE, STARING, with everything I had to DO! Pulling back his sheets, I saw that he was tied to the bed at wrists and ankle and had a wide canvas strap securing his motionlessbody to the bed. "Michael," I began, "You're in the hospital. Thesere was an accident. You MUST WAKE UP!"

Then I gently extended his arm. It immediately sprang into a flex that slammed his fist into my neck. He was refexively combative.

"Shouldn't get too close," the cop spat. I had finished what had to be done to Michael and walked around the bed to confront his 'keeper'.

"WHY is Michael under surveillance?" He looked at Michael, at me, at his shoes. Then, with disgust coloring his rsponse, "Warburton's a hit-and-run. Ran a stop sign and hit someone." He paused, awaiting an answer. Getting silence, he continued,

"Hit a NURSE. She's CRITICAL!" "I see," I said dismissively while turning away. "And hope YOU see you could have had TWO 'critical' nurses if his neck chop hadn't been blunted by my quick movement away. And YOU just sat there!"

"He-is-a-CRIMINAL. And I get paid ONLY to make sure he ain't goin' nowhere."

Enough. I got to work - quickly, efficiently, against the predictable backdrop of machinery cacaphony. Monitors beeped 70 to 90 heart squeezes per minute. I knew what 60 or 100 would sound like. And the respirators - hiss/click, hiss/click, hiss/click - 5 variations on THAT theme and I didn't even have to look up to know that the right amount of breathing was going on. An orchestra conducted electrically. A band that performed while nobody played.

After bathing, changeing & turning Frank, "Both areas look angry now, Frank. But I think with regular care and turning, we'll get you back into a real bed before long."

"Miss Clarke, do you know who's playing in the World Series?" I bent to put his bath things away. "But I'll find out." Now standing, "And I'll see what I can do to get a barber up here." But Frank was fast asleep.

Joe ate unassisted while I got the morning care of the others going. I was starting to panic as "morning" duties were becoming "afternoon" chores. (Their dead weight was hard to maneuver alone.) Visiting hours were from 2 to 4 and I wanted time to spend with what I thought would be a desponded group. Finally, I GOT TO Joe, who'd been observing my rushed ministrations all morning.

"Here, Nursie. Let me help you turn George." "Thanks, Joe. I'm fine. . . .Uh, Joe, will you be able to stay in bed if I don't tie ALL 4 cxorners of your sheet?" (I had really struggled to undo the knots in his sheets,)

"Well, of course. Unless I'm going out. If I'm going out, I have to get out of the bed." Actually, I'd been told the measure was taken to prevent his falling OUT of bed, Probably from a time when he was more heavily sedated, weaker. Siderails will be sufficient, I mentally decided.

"Joe, you just tell me if you want to get out of bed."

"Sure. Sure, I'll tell you. You know I LOVE to play in the World Series. Frank is right, Nursie Clarke. I mean we SHOULD DO something."

Hiss/click, hiss/click. COMMUNICATE; REACH THE PATIENT. RESPECT HIS INDIVIDUALITY. HA! IT'S 2:30 AND WHAT HAVE I DONE? Hiss/click. EVERYONE IS CLEAN, HAD THEIR MEDS, TREATMENTS, WERE FED BY MOUTH OR TUBE. AND EXCEPT FOR FRANK, AND POSSIBLY JOE, THEY DON'T EVEN KNOW IT. I'M CHECKING VITAL SIGNS BUT THERE ARE VERY FEW SIGNS OF VITALITY. Hiss/click. Hiss/click. I HAVE TO BE BETTER ORGANIZED, THAT'S IT. TOMORROW. . . .

I made a list of calls to make after report: Joe, Frank and Michael should have physical therapy; (muscles waste from lack of activity); Dietician for Frank - things he can safely eat in a prone position; the barber; Social Services. (WHY had there been no visitors?) housekeeping - Joe could use an armchair. I just then looked up and through the glass partition of the nurses' station & saw Joe talking to Mulvehill. (Well THAT'S one call I won't have to make. You're not getting out of here today without promising me an aide!) Then I finished report notes.

"You seem to have everything under control." Mulvehill's porcine bulk filled the doorway. She'd startled me but I started my pitch.

"I was just jotting down some thins I . . ."

"You're not having any trouble with Kazinski, are you?" I thought he must be a pet. And she was leaving! Panicked, I shouted her name, started an approach and stumbled. She stared at me which gave me the time/nerve to regain balance/sense of reason, for

"I MUST have an aide tomorrow."

"I'll see what I can do," she threw back over her meaty, cold shoulder.

It was 5 o'clock when I was finally ready to leave. I'd given report at 3 to a wary and disinterested LPN. Then I made detailed notes in each patient's chart and my calls. Only the evening dietician could be reached. She referred me to the day staff. Thoroughly frustrated, I went home. My frustration sank into depression, spiced by fatigue. After a hot bath and boullion, I sat in bed with a legal pad, mapping out the next day's strategy. It was a sterling Nursing Plan. Damn-it! I'll be lucky to get one third of it done! Critical care? Come come. How about "custodial" or, worse, "criminal" care. And then I spid a framed needlepoint Connie had made for me. "Those whom the gods would destroy, they first make mad." I laughed. And scouredstorage boxes until I found an old trasistor radio. "This is for you, Frank. I'll be damned if I'll let your mind rot along with your ass!"

The gods smiled the next day. I had an aide, Mattie. We did the baths and linen changes together, brisquely. Mattie sulked. I ignored her. When we'd finished with Frank, I sent her on a ten-minute break. The woman had seemed nervous - especially around Joe. "Apparently, his charm is eluding you, my dear" I thought. I poured the sugar and Gantrisin mix into the holes on Frank's buttocks and left him using his urinal (which was strapped to the under-side of his stretcher - listening to his radio.

Then on to Michael - who had to be turned. Officer Heeley had made it clear that he had NO intention/obligstion to assist me, so I stood on the arm of his cushy chair, having let the siderails crash merallically down, and boosted myself to a kneeling position from which - now ON Michael's level - I could lean over to roll him toward me. Then. A moan. I looked up, listening. Hiss/click times 5 and, yes, Frank was moaning. Mattie had turned the crank, flipping his body & thus flooding his body with the contents of his urinal. I was there in seconds. Too many to prevent Frank's getting a mouthful.

"Get OUT!" Mattie fled. I helped Frank with some oral cleansing. Then we heard chuckling. Joe, sitting in the lotus position on his pillow, observed, "You're pissed off. Frank'

s pissed on!" Finally, Frank grinned back and I somehow allowed myself to relax.

"Joe, I don't know what we'd do without you."

(Indeed, having learned that the supervisor called him "doctor", I'd asked Jack the origin of THIS sobriquet. Jack just laughed, He was remembering that day when the barber,mhired by the city, was bored and feeling naughty - and had recently seen the hit movie "Dr. Zhivago" - decided Joe needed an Omar Sariff mustache. The resemblance was SO stunning, folks began calling Joe Dr. Z, then just "doctor." Guess Joe thought it MORE than appropriate and started accompanyi ng the attendings and residents when the 'rounded'in the "Unit". Jack said you'd hear, What doe Dr. Zhivago think we should do? and Joe ALWAYS HAD a serious suggestion. It really was hard NOT to like Joe.)

"Would you like to sit in your chair and listen to the radio with Frank?"

"Sure. Sure, I love to listen to Frank. When I'm not busy."

In a way, I was pleased. Joe's response to the situation, all things considered, had beenappropriate and timely. Might even be worth mentioning it to the 'other' doctors. Having fallen hopelessly behind schedule after righting Frank's wrongs, I went back to Michael, mounting the bed more vigorously this time, pulling him onto his back. With the sudden movement, Michael's knee swung up forcefully into my abdomen. I collapsed on top of him, his freed arm locked around my neck. Heeley just WATCHED and my hatred of him gave me strength. I struggled free & used Michael's body to push myself off the bed.

"Don't tell me what your job is, Heeley. You restrain his arm ior I'll report your . . . ."

A new and cold emotion gripped me - FEAR. SOMETHING, what is it? MISSING? DOESN'T BELONG? Hiss/click, Hiss/click times . . .4? I distinctly heard FOUR respirators - and now a low buzz - that terrifying buzz of a straight line going across an ascilliscope. I SCANNED THE ROOM. THAT'S IMPOSSIBLE. THEY'RE ALL ON AUTOMATIC TRIGGER. THEY DON'T TURN OFF! And then I saw Joe - he saluted, proud, teacher's pet. And to his right - Mr. Goldberg and silence.

"I fixed it, Nursie. You see - I just pulled this plug here. . . .and that noise stopped. My pleasure, Nursie." Running to Mr. Goldberg, I fought a violent shaking.

"No! Mr. Goldberg. No. How long. . . When did he. . .?" Thrusting the plug back into its socket, I heard, Hiss/click, click, click, click. The lungs were rigid, resisting the pressurized gas. I thumped his chest vigorously a few times. Then I was on the bed, straddling him, doing - what I knew was futile - massage. Hiss/ click, click, click, click. Finally, someone's hands were around my waist. Heeley set me down and silently walked back to his chair.

"Mr. Goldberg has expired. It was the frosty voice of Mulvehill as she disconnected the respirator plug - again.

I sank down on Joe's bed beside him. "It's okay, Nursie. I'm always happy to help. . . ."

"No. Joe, Mr. Godberg expired because. . ." and I was being force-led to the Nurses' Station bt Mulvehill as she spoke through a nauseating, clenched grin, "Dob;t you think we should talk while phoning in our report?"

Once seated, the supervisor smiled briefly, unctuously through the glass at Joe and then addressed me, tutorially, impersonally,

"Not everyone ARRESTS, Ms. Clarke. "People die." She began to smooth stray hairs back from my brow.

"Mr. Goldberg is better off. You mustn't upset yourself." I raised my eyes and saw Joe - grinning at the face that was above and behind mine. He held his fist with his thumb pointing toward the ceiling in a winning gesture. I heard,

"You must learn to handle these things, dear." and I saw, reflected in the glass, the fat face nodding approval to Joe.

My GOD! This is daemonic! I shoved the chair back into Mulvehill's belly, standing to confront her. She never budged. I searched the sober moonface for some sign of emotion - fear, anger, shame - anything that might alter the sinister possibility - inchoate and repulsive - that was emerging from my messy thoughts. There were none. I forced myself to demand,

:Has Joe ever done this before?"

Undaunted, she calmly said, "I'll finish up in there. Mattie and I can give report. You had better. . . "

"Is THAT why Joe is IN there?"

"You may be interested to know there's been an opening in Critical Care. . ."

"And then again," I countered fiercely, "I may NOT be interested." I spun, walked out feeling relief, sorrow, hope and - most of all - the THRILL of averting a VERY close call - and headed for Frank. "Good luck, Ms. Clarke." and I squeezed his hand. Then I looked at Joe. He smiled broadly.

"Goodbye, Joe." He put his head down and smiled sheepishly,

"Then you won't marry me?"

I stared at him for a few seconds, "God HELP you! There is NOTHING I can do here." Going down in the elevator, I realized my cap had fallen off during the commotion.

"I'll get a new one. And I'll practice nursing in a place where they practice Medicine!"

"Where's my CAP, Millie." or Lorane, RN (Part I)

I received another reminder email from the coordinator of our 45th "GUNS '66 (Georgetown University School of Nursing, Class of 1966) Reunion". Joan was recalling that while we were doing our psychiatric rotation at Walter Reed Hospital -where they treated our military's sickest of the sick - I had suggested she audition for the University's annual musical production. She did, got a part and met her husband of 44 years - also a member of the cast. I was ruminating about my first job after graduation - back home in NYC.

I peeled my nurses' cap off the refrigerator door. It was the first step in what had become a ritual of preparation and, that day, prelude to the commencement of a career. In 2 hours I would report for duty as a registered nurse. The cap had been scrubbed then soaked in a starch solution and finally spread carefully onto the door - all wrinkles kneaded into disappearance - to dry and stiffen overnight. It felt good - hard and stiff, ready to take on its winged shape. It was five A.M and the night still had a tentative grasp on the apartment. Only the fluorescent beam from the oven door shot through the shadowy room to where my hands worked deftly, creasing, folding and securing the fabric with relentless little studs. I placed a rolled sock into each of the wings to discipline curves into submission.. Then, for the first time, I affixed the narrow blue-over-gray grosgrain ribbon which sliced the white span horizontally announcing its wearer was a graduate. I slipped the cap into its plastic bag and shuddered. "What if I can't handle it?"

An hour later I was walking quickly to the subway (there is only ONE pace in 'the city' - "quick") bound for Queens and one of the city's largest city-owned hospitals, Elmhurst General. The "zoo", her former roommate, Connie had called it. Trundling under the East River, I thought of my interview. I'd been appalled by the woman's appearance. Miss Mulvehill was a cartoon of all of the short, plump supervisors I'd ever met. Her yellowed, long-sleeved uniform seemed to strain at the task of containing the abundance of lipoid tissue, which, if ever freed, would roll back and down, slamming her dyed-red curls into the wall behind her chair. Leaning forward on ink and grease-stained elbows, her mass was firmly anchored by the voluminous, pendulous breasts which gripped the blotter upon which my application risked envelopment.

"Interested in Critical Care.," she asked impassively. My trim figure was so tensed I hardly needed the chair from which I leaned forward in confrontation.

"Coronary Care, actually. We had a very progressive program at Georgetown, as you may know, and I . . . "

Ms. Mulvehill thrust her meaty lower lip out and down and slowly slid her finger across its moist surface. Hesitating just a second - to focus on her target - the wet nub then impressed itself on the application, an assist to the movement that would flip the pages to where my assignment would be scratched. Exhaling her interruption, I heard,

"What makes you think you'd like critical care?" I smiled: enthusiasm conquers annoyance.

"Oh Ms. Mulvehill. It's such a CHALLENGE. Those patients are SO fragile, vulnerable and frightened by their illness. And the MACHINES. We forget how threatened they are by the machines. There's such a . . .a RISK of depersonalization. We, I mean the NURSE must keep the patient's individuality in the forefront. (I know. I'd like to slap me shut, too. We were just sooo programmed.) Of course the doctors are SO busy. And the families - loved ones are too often shut out." (BRAIN: SHUT UP!) She had allowed her squeezed eyes to study me during this diatribe. They reported thick, chocolate hair, eased back into a bun at the crown, high cheekbones, walnut eyes framed by thick brows, glazed lips, barely tinted coral and even, 'Chicelet' teeth. She thought, "She's got a ball on the tip of her nose, and on HER it's cute." Reaching for her pen, she scribbled in a manner that precluded recourse. Noticing the definitive move, I heard my voice grow thin as I concluded. Then, speaking as she wrote,

"There are no openings in Critical Care at the moment. You'll be working on N-6. Report is at 7. I think you'll find the experience invaluable." My train of thought completely de-railed, I fought for the presence to ask a pertinent question. "At the moment?" What does that mean. Would there be an opening in a few weeks? By Christmas" Next summer? When? Mulvehill was not inclined toward elaboration. I thought, "She's right. I need a job - now. And the experience."

"N-6. Is that a Med-Surg Floor?" She glanced up and beyond at the wall clock, then rested her gluttonous gaze on a rusted lunch pail which dominated her cluttered desk.

"N-6 is Neurology-Neurosurgery. Call me if you're having any problems."

The train screamed to a halt and I bolted for the doors, aware I'd almost missed my stop. Tried to calm myself as I walked (quickly). "The first day of ANY job is always rough. I'd be even more of a mess if I were starting in Critical Care. Mulvehill did me a favor. I need time to get used to their routines. But Neuro! The damage is so OFTEN irreversible. It's so. . . long-TERM. But now I'm a graduate. More time to REACH people, coax them out of their oblivion. Time. We'd had too many conferences, interruptions. But NOW."

"Did you want six?" snapped a stranger in scrubs. "Six? Six what? . . .Oh, sorry, half asleep," as I backed out of the elevator. Squinting, I approached a deserted Nurses' Station. Noting the disarray of metal charts, lab slips and medication cards, I proceeded to a door marked "Lounge". Must have had a busy night. Maybe an arrest. I hung my coat in a tall, narrow metal locker. The room was "done" in late dirty, torn, unkempt distress-type decor topped with some variety of eating, drinking and smoking debris. Having secured my ("the") cap, I blessed myself and marched out to the patient area. Closing the door behind me, I was staring into a pair of dull, brown eyes about four inches from my own. "I'm Brite. You must be Clarke. C'mon, I'll show you the floor."

I followed the chubby, shuffling frame, fascinated by the black woman's shoes. They plopped. The backs of the laced, white oxfords were pressed in and flat, the feet resting on a now-opened surface, like a bedroom slipper. The brief spell was broken when I started choking on the air. The combo of Pine-Sol and urine stung the sinuses, watered the eyes. (Have not used Pine-Sol to THIS VERY DAY) Steeling myself, I asked the back of Brite's head,

"How many beds on this ward?"

"We got forty beds on this ward. This here is the treatment room," as she kept plopping. Stopping, I pushed the door open a bit. Then. I gasped and smacked my hand so hard against my mouth, my lips were already puffing out.

"Ms. Brite," spoken deliberately and to no one, "this man is dead." The corpse - no covering or ID tag - had been parked for a while, so hard and set were the open eyes and mouth. Closing the door, I caught up with Brite.

"Ms. Brite, you DO realize. . . "

"Jack, here, is the night orderly. Clara's the night charge. We'll make rounds with them and get report." Jack chewed a toothpick, Clara a donut and I my now-swollen lip as we walked to the end of the ward. From the faded-green, rusted, metal beds, the glassy, glazed, confused, unfocused eyes of some twenty-odd human beings stared. Most were diapered, drooling and disoriented.

"What's the current census, Brite?" I was hoarse, stunned by this suffering montage.

"Don't know."

"Jack?"

"ROUND . . .uh . . .thirty-five."

My thoughts sizzled. Around? Well I guess it would vary. We'd just passed two unmade, vacant beds. Their occupants. . . . down in x-ray? Out for breakfast? In the closet? And what about that guy in the treatment room? Isn't anybody going to SAY anything?

"Excuse me, Clara." She stopped, head down, tapping a bed footrail with her pen.

"What happened to the patient in the treatment room?"

"Spired."

Bristling, "I can SEE that he's expired, Clara. Was it during the night? What happened. . ."

"Don't know. He 'spired on evenings and they put him in there. We didn't have time to take him to the morgue."

My thoughts continued their hot race. Don't KNOW? Dear GOD! Poor man probably couldn't take it any more, stole down there - easily un-noticed - and, after clumsily hoisting himself onto the stretcher, blissfully dropped dead. A zoo.

We'd reached the Nurses' Station again. I was making some mental care plans when Brite said, "You'll be in here."

"In here" was a room contiguous with the nurses' station. I'd noticed it in passing. The door had been closed. Thought it was a conference or med room. Brite was gone and Clara lounged on the door jamb for,

"This is Neuro's 'tensive care'," the way a centurion might tell a Christian, "These are cats."

Don't know about y'all, but I'm thinking (I lied. Actually, I've made a decision.) that the COMPLETE title of this post was left off - inadvertently, to be sure. Following "RN" I neglected to type: "Part I ". And I know you'll enjoy "Part II" - hard to imagine, but there's some funny (tho at the time 'black funny') stuff to come that you'll not want to miss. (Of course there have been times I've wished I HAD; just a very few, TEENY times) So then, Later, L. . . .

Nary a Word was Spoken

Just got a wonderful-scary-Enuff!-info-mail from a dear friend. It was a Public Service type of info-sharing dealing with "Smart Phones" - color me oh-so grateful- to be the humble owner of a very DUMB one - and some, a smattering I should imagine, of the perils which they are capable of inflicting on their smart owners. Perish any/all rumors that this writer is/was ever described (with accuracy) as an alarmist. I have far too much respect for the neurotic among us. Indeed when it comes to SELF respect, I confess to being an abject egotist in this arena, ie, the pain of neuroses and I are/have been in a life-long "affair". (. . .five, six, seven, eight SEGUE!)

You see, quite literally, I fear, the daily affairs of one's life become PUBLIC fodder, in-the-world's-face, EVERYONE'S business, just by pressing a button. It's that special button that these special SmartPhones apparently have that (PRESTO!) take a PICTURE which the smart owner can then immediately 'share' (a word I swore off of with the birth of our first grand child. Grams taught 'sharing' & its value to HER children; they can teach it to THEIRS) with one and all. And it seems, ALL is taking facile advantage of this 'Smart' feature. NO MORE SECRETS, FOLKS. EVERYBODY plays/shares. Thus the illustration. Mom & junior share chores. Mom and the world share junior and ALL of Mom's affairs. Just by using your 'Smarts'. Because wherever these casual snaps show up - electronically, the viewer right-clicks ('New-Age' verb), selects "Properties", records the URL ("New-Age noun) and visits same. Before you know it, Smart owner has company - and maybe even 'mail', too!

Pictures. You know the cliche. "Thousand words. . ." Started me recalling. (Surprised?) Had a kitchen window like that, once. Actually for around 25 years. We'll call it my SmartWindow. After marriage & baby # 1, you may recall we landed in Hampton Roads. Bought our 'starter mansion' (white brick, 2-story, 2-BR, black-shuttered number) near the big teaching hospital in West Ghent, Norfolk. Lived there 4 yrs. NEVER got furniture for the living room or dining room. All the kids played at our house. Soooo much space to run around in - on wall-to-wall carpeting, no less. And I did theater, made 'friends', watched their doctor/lawyer/Indian-Chief marriages fall apart - affairs & booze - even started jogging. (In my dotage, I can see now how metaphoric THAT little undertaking was. I was running away from THAT SCENE.) Finally blessed, after ? miscarriages w/ a viable pregnancy, we needed a larger house. (See, you should NEVER "rush in" and furnish a house. You NEVER know when you'd have wasted $ b/c it wouldn't work in a different, properly-sized home.) Our new - and what would be our 25-yr. address: 1125 Westover Avenue. Close to the hospital, Catholic church AND school, populated with young families - future playmates - 4 bedrooms, basement, attic AND buildable 2nd lot behind the main house.

We'd had 'den' furniture and a new den; bought dining room furniture, a breakfast room table & chairs, 'big-boy' furniture for Philip & set up the "nursery" for our second-born, Julie. The living room WAS empty - again - but then there came that show with Pat O'Brien so we quickly purschased a sofa & 2 chairs to plop down on the lovely Pakistani carpet Phil had brought back from his tour with the Commodore. Whew! FA-TI-GUE, TRES FA-TI-GUE! But this time, post-partum (I'd weighed 186 lbs. when we delivered Philip and 176 when Julia made HER Lamaze, posterior-lie entrance) I was determined to whip into shape, Back to jogging and took up racquetball! It was ALL the rage. We had a new "Downtown Athletic Club". We were charter members. I took exercise classes 3 x/wk (there was a manned nursery) and lessons. LOVED it! (Terrified of bees/wasps so the white, pristine, INDOOR racquetball courts were my metier.) I played whenever & with whomever I could. (Once I was in a tournament and had made it to the last round. Soooo excited. Looked @ the elim board & my opponent was NOT the feared-newly-divoed-newly-svelte-always-adorable & super-athletic Helen, but chunky-tres-old-$-ubiquitously-toting-can-of-"TAB"- Bridgette, mother of "Trip", with whom I had no relationship, shared interests or raquetball experience.

Well, en route to our appointed high noon play-off, I was aware of acute, severe, low back pain. Apparently didn't hide it well. Served, lost first point and Bridgette retrieves and ROLLS the ball to me. I WILLED THE PAIN AWAY. AND WON MY DIVISION! (That New Year's Eve we had the BEST party. At the "Club" playing raquetball. And I FINALLY beat Helen. She was as happy as I.) During this time I also played with my next door neighbor, Kathy - gorgeous, warm, true friend and damned good at sports as well and young Cindy, the wife of a new partner in Phil's group. Wifely duty and all that. John, her husband was a good, if bland - by my standards - guy and doc. (Apparently she shared my sentiments but who KNEW?) We began playing more & more often & when not playing, Cindy would take lessons from the club Pro - she & John had no children as yet.) And I had Philip & baby Julie and new, dear friend Ivey - whom I met doing volunteer work for a cancer group - and was pleasantly 'booked' & so glad Cindy had the Pro to keep her busy.

We'd also had baby # 3, Jennie, and it was on the occasion of her first birthday that 'SmartWindow" had its day in the rain. My father had been living with us since Mom's death in '79 and he had taken Philip and Julie on a little vacation to Omaha to visit with my Air Force brother and fam, Phil was working a day shift so Jennie (Bean) and I would be alone on the July 9 First Anniversary of her birth. I dressed her in a pale blue-and-white gingham dress, white bonnet with ruffled brim (a few of her unruly, cork-screw curls forcing their way out around her temples), planted her in the exta-lot grass and took some adorable (what else?) pics. Then we had to venture to -ing">$#@(!?>-ing Newport News on an errand, got lost, hot, thirsty, cranky and ONLY kept going b/c Aunt Ivey had said, "You bring that child over heeya today, hear? I am bakin' my grandmother's special chocolate B-Day cake. And that chile is just gonna HAVE AT IT!"

And so we/she did. Jennie was put in a high chair; entire cake placed ceremoniously in front of her; cameras aimed; SHE HAD A YUMMY BALL, DIGGIN', STUFFING, PAINTIN' HERSELF. LAUUGHING THRU IT ALL! As were we. And all of a sudden, the skies got black (it was around 4 PM); a typical "Nor'easter" was comin' through. (Oh-my-God-I left-the-vinegar-drenched/wrapped-leg-of-lamb-on-the-sill-of-the OPENED-kitchen window to thaw for a B-Day dinner. And it's about to POUR gallons into the kitchen. Gotta go! Love ya, Ivey! Grab chocolate-cake/icing Jennie; throw her into car seat; speed the 20 minutes home during the blinding downpour) As always, enter via back door, Jennie into high chair, proceed to kitchen. Grab roast; dump it into sink; slam window - but: NOT BEFORE SEEING KATHY SCURRYING AROUND HER DRIVEWAY/YARD COLLECTING FOLDING CHAIRS, TABLES, UMBRELLA, ETC & THROWING SAME INTO GARAGE BEFORE LOOKING UP @ "SmartWindow" perfectly-mascara-ed-eyes popping wide at vision of John (Cindy's hubby) fervently-hugging equally eye-popping Lorane.

Quick choice. Focus on Kathy. (John obviously wasn't going anywhere) Start miming wildly while pointing at now dissolving, muttering John: he's not well (tap finger to temple); VERY UPSET - CRYING EVEN, SEE? - Oh-my-God! (wiping my brow, holding chin) "WHAT-AM=I=GOING-TO-DO-WITH-HIM???" Kathy, God Bless her, was the epitome of understanding, aplomb, "heard-THIS-one-before" and just smiled, did the "lips-zipped " pantomime and 'zipped' into the safety of HER back door.

Livid, chocolate-covered-Jennie screaming, I demanded to know what the HELL John was doing in my home. (It seems he'd found some torrid letters from the Pro in a dresser drawer, called Phil - hysterical- and was instructed to call me - lost-in-Newport News - & if I was not home/reach-able - get the key from under front door mat, go into our house, leave notes EVERYWHERE re: his presence/situation (so Lorane wouldn't be be frightened upon 'running-in to him', have a beer & try to relax until Phil got home.) Oh, I see. "Poor thing, can I get you anything?", I did NOT say. It was more along the lines of dis-jointed utterings about a terrified, messed-up one yr-old baby; her mother's now "HOTTEST SCANDAL SCOOP"-circulating in rapid drawl as we live and breathe -YOUR latter of dubious duration; who the F____ looks around the house for notes during a storm when she's trying to rescue a leg-of-lamb + the kitchen in which it is floating; It never occurred to you that 6 days per wk of racquetball was a tad "overkill"???, and so on. And 'SmartWindow" got and had already circulated THAT picture.

So today's infomail - albeit MUCH appreciated - was, for this kiddo, just 'same old'. Even with NO cell phone or a DUMB one, I've been a champ at inadvertent privacy invasion for YEARS!

Later, L. . . .

Get Her to the Church On Time

I was just chatting with one of my children, Jennie. Having "clocked out" of her soon-to-be-not-so-full-time job as a paralegal for an Estate Planning Firm, she was motoring down to the Outer Banks (group of barrier islands off the coast of Virginia and the Carolinas), blissfully alone - and therefore languorously chatty - (Ever notice how your kids will call their work-at-home-Moms whilst they are productively running errands, "So, how's your back?", ". . . CHARLIE Minter. Scott is his GRANDfather. Do you think a 7 month-old would be taking Digoxin and cholesterol-lowering meds? Huh?", "No, Mom. I know you're not on Didge. I'm at the drive-through pharmacy and this moron. . . .") where her in-laws, her husband and their two children and his Uncle and brand-new aunt have already arrived. The occasion: Jennie's brother-in-law, Jay, arrived yesterday with his fiancee, Ashleigh, to spend a weekend getting to know Ashleigh's soon-to-be family. Jay and Ashleigh are in the Air Force. He's with a special helicopter unit and she's a medic. Both will be spending time serving in unfriendly neighborhoods soon after the nuptials in July so THIS weekend is for warm, casual, stress-free bonding.

The Senior Mintons own a modest manse on the sound side of the island where the equipped-with-the-latest/best A-V room, billiards room, outdoor, saltwater pool, dock avec motor boat (serving to augment the 3 bedroom house) should make for some memorable bonding. What with conveniently elevated temps to the 70's, sunshine AND the cuisine of 5-star quality chef Jay - ya think? (To be sure the Minton Seniors' not-quite-miniature pooch, Ruby, will give it up & stop nipping at Murphy, the Minton Juniors' adopted, lab/shep mixed breed, gentle, warm, fuzzy and VERY large, loving pet for the duration) Couldn't help but chuckle (can chuckle NOW. Was certifiable the day of Jen's wedding 7 years ago) when she hung up recalling the preparations for and actual day of the union of Jen and HER husband - a truly beautiful marriage/relationship, bye-the-bye. Come. I think you may have a chuckle or two as well. Our son and oldest, Philip, married his gorgeous bride/marvelous Mom, Robyn in 2000. So this was OUR FIRST show, so to speak. (And Robyn's wedding was an extremely tough act to follow.) Robyn, big-sister Julie, Jen & I had flown to Boston having first made an appointment at THE shoppe to purchase the bride's gown (CANNOT think of the name of the place. Honest) but leaving time to check out other options - like SAKS FIFTH AVENUE where we eventually found THE gown that Vera Wang had obviously created for Jennie (-Bean, her childhood nickname). Julie: "Oh, Bean. . . (tears)"; Robyn: "Jennie-Bean it is. . is. . YOU! (tears)"; Mom: "tears". Simple, strapless, all-grown-up -don't ask. And for the maids - black, strapless taffeta topping biased-cut, black and white plaid skirts. They were to carry multi-colored Gerbera daisies. Two and a half year-old nephew Declan would wear crisp, white linen Eton suit cum shorts. Then we moved on to the cake - tres deco and, therefore, in total sync with the reception site, The (OLD) Cavalier Hotel ballroom, surrounded by french doors opening out to period lanais populated with palm trees, wicker, the aroma of salt air and distant sound of crashing waves. (Scott and Zelda once danced in this room during one of their many visits to his sister in Norfolk. One was just MOVED to call everyone "Old Sport" upon entering) The invitations, the menu, the musicians, guest lists, Nuptial Mass readings and musical selections - a WHIRLWIND of frenzied activity. Oh. Transportation, of course. Well, the church was in Portsmouth, we lived in Virginia Beach - not far from the Cavalier. Soooo, The groom, his parents and groomsmen (Portsmouth) would be limoed to the church. The Bride, her parents, maids, Mistress-of-Ceremonies, photographer and 'helping hands' would dress at our house, take some outdoor candids by the water (carefully) and then -DRUMROLL - board the rented-for-the-occasion antique red-with-gold-trim TROLLEY for a picturesque, quaint jaunt to the church (Portsmouth). Apres ceremony, everyone would be white-limoed to the Cavalier (Virginia Beach). SO special.

On the big day, things were going swimmingly! Those exterior shots were coming out worthy of "Bride's Magazine" and the entire entourage looked stunning and pitched right in to be sure they stayed that way. "Careful! No dirt!" Auntie Sue (by reputation. The kids have known her since they WERE kids. Taught Philip to drive a stick.) was in from California and doing some video cum sound magic with her new computer toys so we were ALL on "Sue-watch" lest a nose scratch or nose pick get memorialized in living color with "I'm just a Broadway Baby!" muted in the background. But we were blessed with spotless success, soil-free snaps, sun-drenched smiles. (You get the picture. Sorry.)

Robyn, characteristically lovely, organized, subtly supervisory, kept a constant, quiet vigil re: the keeping clean aspect of "Showtime, Folks!". And then it was time. We heard actual trolley bells and there in the driveway was the glistening antique trolley, its co-ordinating octogenarian driver listing at attention, hat in hand, memory in the previous century. We queued-up CAREFULLY and marched toward our waiting chariot. Jennie, ably-assisted by Maid-of-Honor Julie, paused just long enough to share her special ride with posterity. Within three turns (0.5 miles) we were chugging up the on-ramp to the westward-bound, three-lane highway. Auntie Sue was in the car following the trolley, lens targeted; my car, driven by one of Julie's Georgetown roomies accompanied by Julie's fiance riding shot-gun and other maid "significant others" in seats 2 and 3. The Father-of-the-Bride and I were toward the rear of the trolley with Dale, Mistress-of-Ceremonies. Robyn, clutching 2.5 year-old, Eton-clad son, Declan's hand and Philip, clutching a large cooler holding "classified" contents, were toward the front.

Wisely, we were in the right lane as the thing barely went over 40 mph. Suddenly, Robyn, speaking VERY clearly, said, "I smell smoke, y'all." Nothing. Robyn repeats, "I said, I smell SMOKE, y'all!" Driver: "Fumes from the exhaust, Ma'am." Robyn: "You STOP this thing and we're gettin' OFF, hear??" Driver: "sputter, sputter". Philip: "Sir," leaning over the bar behind the driver's seat, "Would you mind pulling over? Now? Right here?" By now, we ALL smelled smoke and could actually see little gray clouds jumping up from under the rubber mat at the front door. He rumbled the old heap onto the shoulder. Dale manually opened the center doors. The disembarkation was swift, orderly and proceeded past the now-obviously billowing front of the cab. Then leg up and OVER filthy guardrail, followed by second leg with apparel swiping same in transit and march, gooey march through the soft dirt until everyone was at least 2 car lengths in front of the difficult-to-see-through-the-smoke trolley.

Driver: "Guess I'll call the garage." Philip: (Wildly batting out the flames WITH THE RUBBER MAT from under which they were emitting) "Did somebody get the COOLER??" Fire out. Philip carried cooler to the downstream 'line-up' of our wedding party. (You just have to use your imaginations. Picture this little grouping, sans Cavalier Hotel, standing behind the guardrail of a highway, plaintively, smudgeingly looking out at the VERY passing traffic. I mean did they think these kids decided to get married on VA 264 or what?) Then Fiona: (Very bright, beautiful, childhood, Filipino friend of Jennie's) "You know, Mrs. L, we should have walked the other way. Because now we're down wind of the trolley and if it blows up. . . ." Me: "I tore my skirt two inches at the kick-pleat climbing over that rail." Julie: (Very sub rosa. "Yes, Matt. That was us." into her (they ALWAYS HAVE THEM) cell phone. "Better get off, turn around, make some calls and get SOME of us to church!" Silence. "NOW you notice you're out of gas?!!"

Something REALLY odd ensued. People - as they drove by - were smiling, beeping their horns, rolling down windows to give us 'thumbs-up' signs. Jennie's crying. Make-up running on ALL female faces. THEN. A Jeep-sort of vehicle slowly pulled over. We heard a young man's voice. "You folks need any help?" He responded to our crazed nodding, pulled over and, helped the bride and Julie into his back seat with his 4 year old son. (Mom and Dad were taking him to the Norfolk Zoo) BRAIN: "Well at least there can be a wedding. Hope Julie calls the groom." (On the other hand, we just sent our 2 daughters off with total strangers!) No time to process THIS threatening thought. About the daughters, I mean. In fact, Julie had NOT thought to call Ross. But look. Another car is pulling over. What a nice lady school teacher. She's also the driver of a beige SUV. It's small, but she's happy to take 5 more maids - by having Fiona flat on her back in the rear compartment. Oh, and here's MY car. (They had cleverly gone back to the house & siphoned the gas from Dad's mower. Who carries money to a wedding? Just cell phones.) Now Philip, Robyn, Declan and the COOLER were on their way! It seemed that seconds later, a huge, new tan Silverado - driven by an off-duty Marine - made a quick assessment, collected the rest of us and burned some REAL rubber. Wouldn't you know, JUST AS we were about to get into the Portsmouth Tunnel lane, we hear sirens. Sure enough, we/he was being pulled over for speeding by a state Trooper.

I don't believe that trooper ever met "fear" before he "met" and listened to the lecture given him by Dale: "You should be giving us an ESCORT not a TICKET!" "Do you realize what this young Marine is DOING for this BRIDE AND GROOM??" etc., etc., etc. Ere long, we were on our way again, no ticket, with trooper (and Auntie Sue 'getting it all') behind us. I daresay the Father-of-the-Groom - who'd not heard about the "Trolley Transport" was a tad surprised when his new daughter-to-be arrived.

Of course, time was a-wastin'. Jennie: (Hugging Driver/Dad) "I love you guys. Now you have a GREAT time at the zoo!" Julie: "Let's hustle it up, now, Bean." After getting into the church, the priest who was to conduct the ceremony, whisked us all into a meeting room for some badly-needed freshening-up. GUESTS were beginning to arrive! And not EVERYONE was happy. After all, it had been somewhat of a trial for the wedding party. And Mr. Sleepy as well as Mr. Teary and Ms. Scary-Nervous was there, too.

DAD: "Of COURSE you can do it. Do you know what this is COSTING me? Here we GO!" And they did. It was just every girl's DREAM wedding. (After some post-ceremony COOLER refreshments in the limo en route to The Cavalier.)

As you can see: going counter-clockwise from the group pose cradling the Bride in front of the hotel, we began with "Daddy's Little Girl", moved down to 'Daddy's BIG Girl', across to Cousin Brennan & Julie - catchers of the garter and bouquet, Jennie and Ramone (The GENIUS with the shutter who gave us these memories), Mom and Fav Uncle Chris 'toasting' the cake, Happy Mom with Jennie, Proud Aunt Eileen, mother of dexterous Brennan of garter fame, Dad and finally-relaxed Robyn gettin' down above the Leavy Clan Traditional "Mad Dance" to "MUSTANG SALLY"! (And if you look closely, Auntie "Mad" Sue - in red-really is an official 'Clan' member when it comes to dancing and kindness and gettin' to the church on tape.)

Later. L. . . .

DECLAN: A Story of Capabilities and Limitations

Been a spate of silent days. That blank tape syndrome, you'll recall. Well, actually I was all set - after trapsing through some of my "on air" haps and misses,

to introduce you to a 'pro' I'd profiled back in the day. A guy who did his work well, with flair and devoted following. But what with getting Valentine goodies for the grandpeeps, wandering down the Valentine Memory Lane and then - quite serendipitously, HONEST! - getting an email from a very dear, close, old friend in which she ASKED about one of our children, I am moved to switch gears and profiles and intros and answer her query here by introducing you to Declan.

Recently another dear friend sent me a PDF version of his story which I am told I can deftly place right here. No problem. Of course, no CLUE either as to how this prestidigitation is to be effected (& even if I succeed, I shall probably ALSO "place" every iota of extraneous text/imagery as well) so I will just give it ONE shot & if, after I yell "PULL" & shoot nothing happens, I'll just peck it out for you.

On the evening of February 17,1984, our 16 month-old son, Declan, aspirated a piece of browniie containing fragments of walnut. He'd been laughing. On March 15 - a Thursday afternoon, he died. At Christmas we'd had 4 beautiful, healthy children. I was finally able to write this at Easter. We then had three.
As with all tragedies, much of the experience is personal, unique. But Declan was also a member of a community, a neighborhood, a region. He - and we - were fortunate that he lived in Hampton Roads. If you are fellow residents, you deserve to know why.since we trust ourselves to each other everyday. Today, in 2011, as Americans, you are equally deserving, for the same reason. Declan's story has to do with capabilities and limitations. It is a point of reference from which we can all hope to see progress but with which we must live in "the now". That Declan had to die is, we believe, a fulfillment of God's far greater "story". But we don't ask that you share our metaphysics, just the experience of the way he left; a sharing that is secular and intended to evoke pride and hope.
Phil, my husband, had been a practiicng Emergency Medicine doc for 12 years. I had been a coronary care nurse. Ours, then, was a privileged perspective. Words like 'emergency', 'stable', 'critical'. have poignant, scientific meaning for us. "Baby', 'fear', 'protect' have equally charged meaning. Our professional qualifications allowed us to reconstruct events with clinical observations. Our credentials as parents were the same as yours.
We gathered late for a special dinner that night. It had been a good week for the family Phil and I, 14 yr-old Philip, 7 yr-old Julie, 3 yr-old Jennie, Declan and Poppy, my Dad who lived with us. By 7 that evening, Declan was bored, antsy, cranky. He toyed withe his brownie - mashed it up, spread it around (probably curious as, when I think about it now, he'd never had one before (I don't "do" desserts) and we've not had one since). And he took a bite. He was giggling when he finally stood up, wanting to get down from his chair. "O.K., Helen (often referred to him as 'Helen Keller' who also - initially - had that nasty little habit of cruising around the table, scarfing tidbits from siblings' plates), "it's time for that bath", I'd said, picking him up. Suddenly, I felt him jerk but there was no sound. Movements continued, his face turning red.
I handed him to Phil. He opened his mouth to clear it of food. There was nothing in his mouth. Still no sound — no coughing, no choking. I dialed 911.
An alarm shrieked silently through all of us. This was bad. Experience and exposure notwithstanding, there was terror in the air. My hands shook as I dialed. Yours might too, but you'd dial. Reciting our name, address and the nature of the problem sounded hysterical inside my head and yet I was coherent. The children and my father stood frozen— "Oh my God." "Daddy do something." "Mommy, Mommy." I told them to stand still.

Phil had by this time done numerous Hennlich maneuvers, applying sharp pressure to the abdomen to force air up and dislodge the obstruction from the windpipe. They didn't work. He alternated blows to Declan's back and chest. Nothing. The look of frustration and disbelief that I saw in my husband's eyes was undoubtedly mirrored in my own. We had to go beyond mother and father and son — and function. We brought him over to the counter by the kitchen sink and began cardiopulmonary resuscitation (CPR). When I tried to breathe into his nose and mouth I met with total resistance. Something was stuck in his airway. Phil quickly repeated all of the previous maneuvers to try to clear it.

I brought the girls and my father out to the front hall, turned on all the lights, and opened the front door wide. I told them to pray and direct the paramedics to the kitchen when they arrived. Phil was vigorously massaging the baby's chest and blowing into his mouth. Declan was gray and stiff; stomach contents were oozing out of his mouth and nose. We suctioned him with our mouths. The telephone rang. The paramedics. "MY GOD, haven't they left yet? Didn't they believe me?" In fact, they were en route. They questioned Philip, who stood next to us and relayed what was going on. Which was: "He's vomiting Phil." "No, he's dying Lorene." "Then you'll have to do a trach." "I can't." (Trach refers to tracheostomy cutting down into the windpipe so that a tube can be inserted to breathe a patient.) Philip, fighting for control, "They want to know if he is in respiratory or cardiac arrest?" "Both!" I handed Phil a kitchen knife as we hyperextended Declan's neck, his soft, blond, feathery hair fanning out
into the kitchen sink. "My dad is doing a trach, now." Phil somehow cut the skin. The blood was dark. No oxygen. The windpipe was so small. The drinking straw and the cut-off bail point pen were too big to use as temporary airways.
There was madness then, of a sort. "Don't die Declan," "BREATHE, baby!" "NO, God, no." Phil grabbed Declan's head and blew with all his strength into his mouth. We finally heard it — a wet, croaking gasp. Phil had blown the obstruction down and into the lung. The blood flowed freely and bright red now as we continued what became effective CPR. I checked his groin. He had strong, regular pukes. We all knew Daddy had brought Declan back. Phil and knew how much deadly acid and oil we had blown into his lungs. But maybe....
Suddenly — uniforms. The paramedics were in the kitchen getting out the equipment that would keep Declan breathing and beating so he could be moved to the hospital. They began four minutes from the time I had dialed 911. How hard it must have been for these young men. Phil
taught and trained the Emergency Medical Teams (EMTs). They are, in a sense, tested by him daily. With feelings of disbelief. trepidation and desperate urgency, they faced Dr. Leavy in his kitchen — a battlefield of blood, tears and vomit — for the most comprehensive of tests: to stabilize and transport his near-dead little boy. We had prayed for them to come and were so relieved to see them. But when we faced the fact that we had to relinquish control — stop doing things to and for Declan with our own hands — we felt the first blows of impotence which would continue to reign for the next 27 days.
They moved Declan to the breakfast- room table and began attaching the nuts and bolts of the life-support system that would allow safe transport. I checked on the other children, returning to find the paramedics and Phil still at it. Declan had gagged out the first breathing tube so they were putting in another. They were checking the position of this or that, and finally I couldn't stand it any more. "Can't we just get going?" "Well, M'am," he answered calmly, "we want to make sure he has a good I.V. running in case he needs any medicine on the way." I knew this. I had no right to say that. I apologized, and he understood. They seemed to be taking hours, but it was truly a matter of minutes. They do so much — tedious, complicated things — so quickly and so well that the helpless, terrified person standing by wants to say mercilessly, "Listen, hot shot. this is your job. Can't you step on it?" Well, it isn't — a job, that is. It is a series of highly skilled maneuvers performed under difficult conditions and aimed at saving a life. There can be no interference. It was agreed that Phil do the intubation, but beyond that we handed Declan over to them.
They were aware of our knowledge and our eyes. They executed their tasks flawlessly, speedily. They found time to comfort and reassure us. We ran blindly down the front steps. They remembered the blanket and to move with a coordinated effort as they carried Declan gently out into the chilly February night. We were grateful to and for our paramedics. Trust them with your lives.
And the police. A garden of squad cars outside. Police in every room. Now we adults know, don't we, that the police are there to help us. But there is still a vulnerable child that plays in the back room ofall our minds who says, "Police — must be trouble." There also is a vulnerable
grown-up standing on the front porch of our minds saying, "No problem — you all can go home now." So it is with a strange ambivalence that we seek and accept help. Part of me wanted to minding the rest of Norfolk?" But the crushing truth was that they had answered a call to 1125 Westover Ave.. a place where tragedy was in progress. And they were needed there — now sitting on the stairs holding Jennie, now kneeling, arms around Julie, watching Declan being saved. Standing beside Poppy. allowing him to cry. Talking with Philip; praising his courage, his father's work. Offering to calm me and accepting my rejection with mature grace. Washing the blood from the sink and cabinets. "The children shouldn't have to look at this." the policeman said.
They made the unbearable bearable.No one wants cops in his house, but we demand that they be right under the window when things go bump in the night. They must walk gently amid the rubble of human emotions. It's ugly — what they must see. It's beautiful — what they do. The next time you're talking to a police officer— waiting for your ticket or whatever say thanks for us.

The Emergency Room. Our other family. Stunned and silent. they
reined in their emotions and worked to correct the imbalances that could threaten Declan's life. We were in a small, quiet room. a place for shaking. crying, praying. We did all of these things and drank the first cups of what would be vats of coffee drunk during the long vigil. Softly-spoken words of encouragement, assurance of prayers. offers of continued support were all around us. Finally, Declan was ready for transfer. Everyone wanted to do more, to say he would be all right. But, like us, they could only surrender him — and hope. There are no routine emergencies. Declan's presented the dilemma they face each day — "Let what we've got be enough to save this life." They did what they could. And then they cried. That's part of emergency medicine. Maybe you didn't know. They cry for all of us. It's something to think about when the E.R. is crowded and you have to wait a long time to be seen for your earache. Declan would eventually that the available, known treatment used to keep him alive contributed to his death. At the house having no suction, we had to blow large amounts of destructive fluid and chemicals into his lungs along with the oxygen he needed. Whatever lung tissue was still healthy after that had to be helped along with high concentrations of oxygen and pressure to get the job of oxygenation done. This tissue eventually was damaged from the prolonged use of high oxygen and pressure. It was unavoidable. On the night of February 17th, the doctors could only hope that the initial
while his lungs healed.
There was a very special, state of the art place in your midst called the Pediatric Intensive Care Unit at The Childrens Hospital of The King's Daughters. There were two, full-fledged, experienced pediatric intensivists there all the time along with a highly skilled. educated and astute group of nurses. Add to this the endless and immediately available lists of specialists, residents and social service personnel and you know that this unit is nothing short of superb. We lived with these people and what they do for 10 days.
Their work is demanding, exacting. One drop more or less of a drug can take a life. Reading and correctly interpreting the maze of machinery attached to each patient can save entrusted to them gives new meaning to the words critical, fragile. The little people themselves give new meaning to the words loveable, vulnerable, helpless. The thing that comes to mind when I think of that staff is love — in all of its meaning. Their challenge is to fix the smallest and the most broken among us and to grab the little body from which life has almost completely drained, find the hole and plug it. They know some of their patients will die. But they never know which ones. Wouldn't it be easier, emotionally, to focus completely on the machines.
the numbers, the cold — but reliably there — steel and polyethelene aspect of their work? Sure it would. Instead, they love the child, love the family, over and over again.
It's a very high risk kind of love. He would hear friendly, cooing. comforting voices always around him. "Mr. Clown's gonna play his music, Declan. I'll put him on your head so you can hear him." "Let's see what the kids did today, Declan." (At the doctors' suggestion, the children sent daily tapes of their activities so Declan could hear their voices and they could be with him.) We knew about the nurses' hugs and kisses, their prayers with Declan. They were saying, "I'm gonna love you, you tricky little kid, even though it's gonna hurt like hell if you die." They had to face us and the children, day and night, answering so many questions in such detail, having to admit to that awful set of limitations. They desperately wanted the miracle to happen but after 10 days Declan's lungs were saying they couldn't function with the high pressures. Only a jet ventilator could deliver high oxygen with low pressures.
So, having worked so hard for so long, they had to turn their littleguy over to the Medical College ofVirginia for the only chance he had left.
It took 24 hours to fly the ventilator and a qualified inhalation therapist to Norfolk, prepare this special KD van, and then move Declan and all of his paraphernalia up to Richmond. It was with great care and courage that our doctor, nurse and paramedic escorted Declan to MCV. It was with great reluctance, hope and love that they left him there. It hurts not to be able to do the miracle.
Phil and I went up alone and settled into the Ronald MacDonald House. It felt safe and good — being in a house. We missed the kids. We were tired, scared. edgy. The staff at MCV would be edgy as well. Their new admission was a rare case a kid who had survived full arrest and serious aspiration in his kitchen, had normal brain function, no heart or kidney failure and had exhausted the miracle supply at KD. Only his lungs were shot. Would the jet ventilator be the key? Despite these dreadful odds, their embrace of Declan and us was complete from
the first meeting. Declan did not improve on the jet. Phil asked about ECMO — Extra Corporeal Membrane Oxygenation. It's like a heart-lung machine. Maybe we could rest Declan's lungs so they could heal while ECMO kept him alive. Consultations were made. It
wasn't recommended. It has been used successfully only on newborns. But, "We happen to have an ECMO team right here," they said.
The next day Declan started to decline rapidly. The ECM() team was
called. They would try to get him on. While they primed the pumps and the intensivists worked to keep Declan going. the surgeons explained to us how slim the chances were of surviving the treatment. There was a great danger of hemorrhage on ECMO. Any infection is fatal. The
pumps are geared for the small volume of blood in the neonate. Declan could die for any of these reasons. (Of course, we were in a large city, in 1984, with AIDS making a strong debut, priming his pumps with 24 units of donated blood. It gave me pause then and now.) If he doesn't get on ECMO, we thought, he'll be dead tonight. Yes, doctors, we understood. We signed the papers. It was a difficult discussion far all of us. They hated what they had to say. There would be a time limit. He could stay on for only 10 days. Any longer and hemorrhage would be certain. We could only hope that he could live on ECM() and his lungs would heal enough to work again on the jet. "If he makes it. he'll be the first in the world with his kind of disease," the surgeon said. They began at 4 p.m. At 2 a.m., Declan finally was on ECMO. Our children joined us the next day. team. The staff gently prepared the kids for the pumps, the motors, the tubes, the bleeding they would see. They helped them to see Declan under all of this to talk to him, to listened. They heard the truth. They saw how never to lose hope. And that other families had tragedy. They made friends. They learned how to support and be supported. A child Declan's age on ECMO was a new frontier. There were many technical problems, many close calls. We've After 14 days, the time came to turn off the ECMO machine. There had been no change in Declan's lungs. We talked to him, told him how much we loved him and would miss him. But we knew he had to leave and it was — would have to be — all right. He squeezed our fingers, wrinkled his nose when we blew on his face. His touch and reactions were playful, not desperate. Declan was not afraid. He knew no pain. no strangeness. He did not die alone or in silence but in the company of people who loved him enough to say goodbye.
MCV belongs to you. too. You needn't fear impersonality, a syndrome associated with large medical centers. It is warm and friendly, and people care. These same people made medical history that March. Other children will live because they had the courage to put Declan on ECMO. Maybe that was part of Declan's mission. Another part might be that two other children can now see with his corneas, still others fought their cancer with the juices from his thymus gland.
At Declan's funeral, there was a line of rescue vehicles, EMT's standing at attention. Nightingale (our rescue helicopter) hovered overhead at the gravesite. The staffs from KD and MCV were there. We released a dozen helium-filled baloons to escort him - and returned the salute to the gathered honor bearers. Declan could have left without a trace. He's left some rather large footprints for a little guy. But then, look at who his friends were.
Valentine's Day will be happy today - as it was in 1984. I'll more than likely NOT say the same of the Ides of March, 2011. L. . . .