goodbye

Yesterday morning I took care of a three year old boy. He had showed up at our eye tent last week with his mother and baby sister. The mother gave an admission history that made it sound like the boy had a severe infection in his eye, which was plausible to his clinical symptoms.

However, when they preformed surgery on the eye they found long extensions of a brain tumor that had thick extensions down the optic nerve. His brain was most likely filled with tumor. They eye trouble was just the surface level problem.

Yesterday, when I came on to assess him his heart rate was dangerously low and he was taking long, intentional breaths, probable side effects of his tumor filled brain.

I have been at the bedside of dying children before and it was obvious that this little boy was near the end of his life.

At home, working in the Intensive Care Unit and the #1 Children's hospital in America, there were still times when I took a patient down for an MRI, only to return with the tragic news that there was nothing we could do. The child was going to die and all our skills and resources could not stop it.

It's always heartbreaking.

There was nothing we could do for this boy, so we sent him home.

Before he left, we had a thorough discussion with the mother to make sure she understood what was happening to her little boy. She understood.

She is a single mother with limited family and very few friends. She has few resources and little money. Her shock was apparent. I'd don't know how she will cope with her child's death. But it doesn't matter if your rich or poor, black or white, American or Liberian, a mother's heart is always a mother's heart. Sending a child ahead is cripplingly painful.

Before he left for home, I was able to hold the boy in my arms for about fifteen minutes. His face was thin and his body slightly emancipated. He was in a state of peaceful slumber but every so often would open is eyes and give a gentle yawn, then he'd go back to sleep. I held his head close to my neck and he buried his head into my chest, surrendering his little strength to my arms.

He didn't seem to be in any pain. His body looked calm and peaceful.

When I took his IV out, I was somewhat happy for him. We weren't going to intubate, or place a central line in his neck, or give him medication to increase his blood pressure. We were going to let him go. Naturally. Peacefully. Quietly. Calmly. Beautifully.

Being with a dying child is a bittersweet experience. A part of you breaks thinking of the sorrow their death will cause friends and family. You break thinking of the injustice that a child be cheated of their life. But a part of you feels an amazing sense of privilege that you are in the moment. You are one of the last people to stroke their forehead and gently hold their arm. You get to cry with the broken mother. It's very powerful.

When I see children suffer and die, it always comforts me to think of the host of angles that must be sent from heaven to earth to ease their transition into heave. I think of Jesus, who gently said, "Suffer the little children to come unto Me." He who has a special place in His heart for the weary and weak surely must give special care to the little ones He takes home.

I was privileged to be the hands that held him here. Amazing.