Influential case #4

During my senior year of residency I was covering the oncology service. It was a relatively slow night and all of the kids were stable. Around 3AM, a seven year-old, thin, perpetually smiling girl with extensive lymphoma called me to her room.

It was dark when I walked in and, as I allowed my eyes to adjust, I slowly walked to her bed. She was lying on her back with her hands behind her head and hew mom was curled in the fetal position, facing the wall.

She whispered, “I really need to go to the bathroom, can you please help me? My mom needs to sleep and rest for tomorrow.”

I happily agreed and softly lifted her to the bedside commode. She pulled down her pants and sat down. After a few moments, she said “I’m all done. Can you wipe me?”

I grabbed some tissue, gave a quick wipe and started to lift her up.

Something immediately seemed off with her, but I wasn’t sure what it was. As I hesitated, she shyly mumbled, “You did a really good job wiping up front. But I need you to wipe in the back too.”

As I reached for another tissue, we both broke into uncontrolled, but quiet, giggling.

After finishing my job, I put her back to bed and she quickly fell asleep.

By noon the next day, she peacefully passed away.

Moral of the story: Children are much more mature than I often imagine. This young girl was aware of the fatigue and stress crippling her mother and wanted to help alleviate some of the burden. I was also amazed at her understanding of human nature. She gave me positive reinforcement before the constructive feedback.


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