“Maddie certainly is your daughter, Niki. The family resemblance is startling,” laughs Gerald when I tell him and Liz about Maddie’s pranks.
“Gerald, are you calling me a smart ass?”
“Amber should lighten up a little,” says Liz. “I’d give anything if Nathan pulled simple hijinks like that instead of staying out all night, and skipping school. Amber has no idea how difficult a teenager can become.”
“How is Nathan?” I ask.
“He was suspended for smoking on campus again. When his locker was inspected, they found some pot. He’s missed so much school this year I’m afraid he will have to repeat his junior year unless I can get him into summer school. He used to be such a good student, a good boy. I can’t find a way to reach him.”
“Is his dad any help?” asks Gerald.
“Frank? No Frank’s part of Nathan’s problems. He’s an alcoholic. Our marriage was pretty bad. It took me a long time to learn that I couldn’t save him from his drinking. Or that it wasn’t my fault he hit me. Nathan got between us once, and Frank hit him really hard. That was when I finally realized we needed to leave. I thought I was helping Nathan by keeping our family intact, but I stayed too long.”
“That’s a hard decision to make sometimes, Liz. I’m sure Nathan will have more understanding when he gets older,” I volunteer.
“I can only hope. His behavior is so reckless, I fear for him. Every time we admit a trauma from the ED, my heart pounds with dread, wondering if it’s Nathan.”
I give Liz a hug, and Gerald pats her shoulder.
“Have you considered taking Kris’s day shift position, Liz? Would that help things at home?”
“It wouldn’t help. I’ve lost control. Nathan walks in and out as he pleases. I can’t afford to lose the night shift differential either. Money’s tight on a single income.”
Something about Liz’s words gives me goose flesh.
* * *
We get two admits from the ED. The first is an eight-year-old new onset Type 1 diabetic. He’s admitted with a blood sugar of 550, and semi-comatose. Dr. Polk intubates him, and we start IV fluids and an insulin drip, drawing blood sugars hourly.
His parents are devastated by the news that their child needs daily blood sugar monitoring, and insulin shots. Then Dr. James, the pediatric endocrinologist arrives. It doesn’t matter what time of day or night a new diabetic is admitted to our PICU; Dr. James shows up and spends as much time as needed to explain to the parents that their child’s diabetes is manageable. He cheers them up with stories of athletes and celebrities who are diabetics. He’s so kind and gentle. I love standing in the room watching the parents’ anxiety come under control while he teaches. He is passionate about his practice, and my favorite physician.
The second admit is a six month old with a respiratory infection. After failing to respond to Gerald’s inhalation treatments and chest percussion, he buys an intubation tube and ventilator. His mother sleeps in the cot by his crib, finally able to rest after hours of worry about her baby.
It’s three in the morning before I sit down to eat the sandwich I brought from home while catching up on my charting at the nurses’ desk.