Or Not to Be (21 page)

I remember the day when the first code was
called on then three-year-old Ben. I excused myself from my consultation and
started my run. Nurses and doctors universally describe this race in the same
manner: it is a slow-motion sprint. No worldly speed is ever fast enough;
gravity amps up to exert an additional negative force vector—like iron chains
on your ankles—as you run. Your legs pump, muscles burn, like your own life is
on the line, with death trotting at your side, taunting you, all the way to the
room with the dying child.

I arrived at Ben’s door and found two
nurses and a resident surrounding his bed. They were listening for a heartbeat,
adjusting his IV, watching the monitors, calling out what they found—a symphony
of medical professionals working to keep the body’s trillions of molecules
oxygenated and viable in case the patient came back. When the patient is three
years old, thirty pounds, and limp, the symphony plays its beat in all eighth
notes. This is the essence of what we do—provide maximum time, extend the
workability of the body, the matter, and keep the space-time gap stretched open
to give the soul a nice wide window to make its choice. We give the hitch a
chance.

The code cart came in right behind me. I
absorbed all of the information from the team in seconds while my eyes scanned
the monitors that showed Ben’s pulse, oxygen, brain waves.

“Pulse forty and dropping. BP eighty over
thirty-five.”

“Oxygen at fifty percent.”

We were losing him fast.

“He stopped breathing.”

“Beginning CPR.” A nurse got on the bed
with Ben and bent over his tiny body.

This was the process. CPR, then intubate
if there was not a DNR order. When his heart stopped and the brainwaves
stopped, we had five minutes to bring him back with the defibrillators. All of
the equipment was here. It was my call.

Although I was working frantically with my
team, I felt myself stepping away and watching the action. I often had this
sensation when emergencies galloped at light speed. Somehow the five minutes
lasted hours. Time warped and slowed. The feeling of doing the same things over
and over and over was common. That was the hitch in time. I believe this was
when the antimatter came back.

Ben came back.

When one of my little patients did not or
could not return to us, there was no hitch or slowdown in the emergency room
drama. Time slammed forward at a breathless pace and relentlessly beat us to
the finish line. Even the best medical teams could not keep up. Afterward, when
the time of death was called
, the tender absence of
the young soul was physically evident
. In those cases, I knew the
child’s antimatter departed quickly and painlessly. No decisions. No agonizing.
A clean break. What lay beyond to greet the antimatter in death was all good.
The child would be cared for and comforted by the entire universe.

Ben’s mother sensed his deathday and made
a point of having her son in the hospital every year in early February. A few
years after his first death, I was called at home about him by the head nurse.

“Dr. Wixim, Mrs. Martin is here with Ben.
She’s insisting we admit him. There is no medical basis—his temp and oxygen are
both normal, white blood cells slightly elevated but not alarming—so her
insurance refuses coverage. She won’t take him home. What should we do?” Sandy
was one of my favorite head nurses. She loved the kids and supported their
parents through the worst living nightmare: watching their children die. Ben
and his mom depended on Sandy for consistent pain management and
middle-of-the-night jokes. Right now, dealing with a panicked mom and a
stubborn insurance rep, she was all business.

“It would help if I could talk to Mrs.
Martin. Is she there with you?”

“Sure is. Hold on.”

“Dr. Wixim? This is Candace Martin, Ben’s
mom?”

“Yes, Mrs. Martin. Tell me what’s going on
with Ben.”

“Well, it’s hard to explain. So far
everyone has told me to just take him home. But I can’t.” She paused, and I
heard a sniff. Then she stated this as a fact, “Dr. Wixim, if I take him home,
he’ll die.” She rushed on, “I know this sounds crazy. But I also know that I’m
right.”

That’s how it was with the space-time gap.
The deathday was a mystery to almost everyone. Those who had some inkling of it
were puzzled by it. Parents who knew their child’s deathday were paralyzed,
even when they had no idea how they knew, or even what it was they knew. They
suffered from relentless and mysterious anxiety, both physical and emotional,
when the planet revolved to the proximity of their child’s deathday. Ben’s
mother felt his deathday pulling her son away and knew that he’d almost died
this week in February twice before.

“All right, listen. I have some questions
for you. I could ask Sandy because they are medical issues, but it will help me
know what to do if I hear the answers from you. Okay?”

I heard a small gasp of hesitation. “It
feels like I’m about to take a test that I forgot to study for. What if I give
the wrong answers?”

She was a mess and didn’t know I was on
her side. I was also certain Ben’s deathday was coming up and that he was
dangerously susceptible to the force it would exert on him in his weakened
state.

“Candace, if your son is going to die
soon, being in the hospital might not help him. But I’ll fight with your
insurance to admit him. Just help me find a reason.”

“I’m ready.” She didn’t sound convinced.

“Does he have a fever?”

“No.”

“Is he complaining of any pain?”

“No.”

“Diarrhea or constipation?”

“Always one or the other—from his meds.”

“Is he sleeping?”

“Yes.”

“Is he disoriented or—”

“Wait!” she interrupted. “Sleeping. That’s
it. Actually, he isn’t sleeping well. He falls asleep easily but he wakes up
four or five times a night.”

“Does he stay awake? Insomnia?”

“No. He goes back to sleep.”

“Does he complain of pain at night?”

“No,” she said,
“let me think a minute. See, Ben doesn’t even wake me up when he does. He tells
me in the morning that he was up. He worries that I need
my
rest. In the morning I always ask, ‘How’d you sleep?’
and his standard answer is ‘Like a rock’ or, when he’s feeling silly, ‘With my
eyes closed.’ He learned those from his dad. But lately, he just talks about
his dreams. His dreams are waking him up.”

“Are they nightmares, did he say?”

“No, not nightmares—he never seems afraid.
Well, you know Ben isn’t afraid of anything. No nightlight, none of that jazz.
He’s good at falling asleep. He likes to sleep.” She paused. I didn’t interrupt
her thoughts. I waited. Then she said, “He’s dreaming that he’s talking to my
mom.”

“Is Ben close to his grandmother?”

“He was,” she said, “before she died.”

Then he was hovering nearby, feeling the
edges of his space-time gap. She was right that he could die. I didn’t know what
I could do about it, except grant his mother’s request for support. “Candace, I
need to examine him right away. Put Sandy on the line.”

“Oh, thank you so much.” She was crying.

Sandy’s voice said, “I don’t see how this
will fly, Ed. You can’t admit a kid for nightmares.”

“I can. And I am. Admit him for
gastroenteritis and insomnia. I’ll wrestle with the insurance later, and I’ll
be there in an hour.”

“Insurance will deny it,” she insisted.

“Of course they will. That’s what they do.
But you know at the end of the battle they’ll always cave and pay for the care
of a dying six-year-old.” I hung up and told Anna I was going to the hospital
for a couple hours.

The Thursday I brought Bethany to see Ben
was February tenth, one day after his deathday. His mother had been right. The
day before, his heart had stopped. No pulse. No brainwaves. We called a code
and worked on him for minutes that felt like days. And he came back to us. When
I walked in his room with Bethany, he was napping. The room was dark.

Bethany heaved a noisy sigh and whispered,
“Who will play War with me, Daddy?”

Ben rolled over and saw her in the doorway
and, still groggy, said, “Whatcha’ doing here, Beth-Bomb?”

She snorted and said, “Came to smell ya,
Ben-Bomb.” They both burst into giggles.

I opened the blinds to let in the winter
light. I patted Ben’s foot and read his chart while Bethany jumped up onto the
bed with him.

His chart indicated hourly checks of blood
pressure and temperature. He was steady and strong. Lungs were clear. Other than
being tired, he was ready to go home.

“Wanna play War?” Ben asked as he pulled a
double deck of cards from under his pillow.

Bethany beamed and nodded. They split the
cards to shuffle. No dealing required. They made two piles of agreed-upon equal
heights and started warring.

I kissed Bethany’s head and messed up
Ben’s mop of new hair and continued on my rounds. He was doing great. He was
going home again.

As a pediatrician treating terminally ill
children, I could predict who would come back based on whether there was that
hitch when they died, whether I had the stepping-away-from-things feeling and
the incredible second-by-second déjà vu. This was when the antimatter would
return. Their space-time gap opened, and I am convinced everyone in the room
would have felt it if they knew to expect it or knew what it was. I watched my
peers for evidence of this knowledge. But, even in this, I was isolated.

The times that I’d died were not easy for
me. My experiences from the dead side made me a better doctor, but also served
to alienate me from normal humans. I knew that it would be impossible to
explain what I knew to anyone who’d never survived death, so I never tried.

When Anna died, I felt the hitch. I’m sure
I did. That was two days ago, and I’m still waiting for her, trying to be
patient, hopeful but helpless. Everything I could’ve done to influence her
choice to return to me is now in my past. On the living side, there’s no going
back in time to repair mistakes. They gape open like rips in our relationship. Maybe
Anna can look past our last few months. Maybe she’ll forgive me.

Maybe not.

34

Many of my kids in oncology
lose all of their hair during treatments. They don’t
just lose their headhair, as Bethany used to call it, they lose eyelashes and
eyebrows, too. Though it bothered Bethany at first, she became accustomed to
it. After accompanying me on my evening hospital rounds, I was surprised when
our first-grader, with glorious chestnut hair, asked me about my bald young
patients.

“Daddy, Jess doesn’t have any hairs.
Katie, too. Aren’t old men the baldies? Little kids—little girls are ’sposed to
have hairs like me, right?” She sat up like a puppy in the front seat of my
truck, watching every detail of the world go by.

“Yeah, Bethy,” I said as I rubbed the top
of her little head, “they’re supposed to have beautiful hair like you. But the
medicine to make them get better takes their hair away.” It was a tough concept
to explain to my healthy little girl.

“Hey! There’s my school! And there’s the
swing that Maddie wouldn’t share!” She frowned at me. “Medicine takes away
hairs? Why do you give them that medicine, then?” She absently stroked her long
ponytail.

“It’s called a ‘side effect.’ The medicine
fights the bad cancer, but also eats up their hair.”

“Ick. Hair-eater,” she pondered with a
sneer. She looked out the window and announced, “Look! A field of cow!”

“Cows,” I corrected her but immediately
regretted it.

“No, Daddy,” she argued. “Mom said we
don’t have to add s to cow. She said they’re like deer and fish. My teacher
marked it wrong on my spelling test and Mom wrote her a note.”

Bethany never doubted a word her brilliant
mother said and wouldn’t believe me or her teacher, so I didn’t argue. She
turned back from the field of future burgers and asked, “Will they always be
baldies now?” Like her mother, my daughter was capable of multiple,
simultaneous, unrelated conversations—from a field of cow to the side effects
of chemotherapy to who knew where we’d go next.

“It takes a while, but usually the hair
grows back.” If they live long enough.

She held up her long ponytail. “I have
lots of hairs. Can’t I give ’em some of mine?”

Ah, there’s that missing s. I smiled but
didn’t correct my daughter this time. This was her mother’s territory. I’d
heard Anna, while tucking Bethany in one night, try to explain why, even if
there are a hundred pieces in a bowl, we still call it “popcorn” but we never
say we have a bowl of “potato chip” unless there is only one left. Bethany had
argued if there was only one potato chip, we wouldn’t even need the bowl. They
giggled together over that and plural words became their bedtime game—to s, or
not to s.