So much noise from such a small child...

The Screamer

There was a loud screaming sound that greeted me that day as I entered the ER doors to start my evening shift. It was so shrill that on the back of my neck was hair standing at attention as my eyes searched for the source of that awful noise.

I could not believe that much volume was coming from her little lips. She was only 12 years old, bone thin and very frail. Her eyes were big and a beautiful shade of blue. Thin, fine, sweaty hair was matted and clinging to her head. The look of complete despair covered her little face.

I walked passed her bed and to my locker to secure my things, then headed back into the scream zone she had created and continued to maintain.

I picked up her chart and saw this huge word that described what was destroying this tiny 12 year old girl...it was Adrenocoritcal carcinoma (her mother called it stomach cancer, probably because the daughter would say, “My stomach hurts”, but it is actually a kidney cancer).  A horrible illness at any age but made worse when a child has to suffer with it. Her parents carried with them all of the information about her condition and its progression. Her current treatment regimen and medicines were also presented to us. It appeared that her parents were accustomed to the sound of her screams, but I could see this had taken a toll on them.

The mother was eager to talk about her daughter and about their life as a family. The mother had once been an opera singer when they lived in Miami. She continues to sing but they had moved to a totally different area. They now lived in Memphis, it was a place that offers more of a country, serene environment to care for their children and also it was only 10 minutes from St. Judes Children’s Hospital where her daughter is treated. There was improvements in her daughter’s condition (Channing was her name), so they took a  bit of a risk and drove to Florida to visit family. She said it had been so long since Channing had been well enough for such a trip and this might be their only opportunity. A child fighting this kind of battle is so unpredictable, they had to jump while things were going smooth in her treatment.

They were just passing through Mobile on their way home and Channing suddenly was in so much pain that they had to locate a hospital and we were the lucky one. I enjoyed meeting this wonderful family and it helped me to see just how fortunate I am to have healthy children and grandchildren. 

After all of the testing was done, Channing did have to be admitted and later had a minor surgical procedure to stabilize her before she left our facility. Unfortunately, that had become a way of life for her and her family and I could not see a bright future for them.

Later in that shift, we had a female patient about 50 years old who was suffering from severe abdominal pains like Channing had suffered. This woman was a chronic alcoholic and she suffered from pancreatitis and some malfunctions of her liver. She trembled as she lay there suffering and I could feel her misery as I tried to comfort her with my words.
She was in so much agony. She also told me of her shame that she played a part in her situation. As she spoke I noticed she looked lost in thought. I could only imagine what she might have gone through to get to where she was today. I felt just as huge emotion for her suffering as I did for Channing. I also knew that her situation would likely continue to deteriorate, just like Channing’s would.

I learned early on when I began working in the ER that it would be painful. It was painful to see and to feel the things these people were experiencing. I knew the only way I could cope was to care for them, to try and brighten these moments in their lives as best I could and then to put my feelings on a shelf. I realized that I could not bear the continuous weight of the pain and sadness there and live happy. In my mind I will still occasionally revisit my memories of these patients, I feel what I felt in that moment of time and hope their lives are better now as I know this is something over which I have no control.

We all want to protect our children, but sometimes it is out of our hands. I speak from experience as one of my sons had cancer at a young age and there is nothing to compare to the fear it brought me.

My sweet grandmother used to say, “I wouldn’t take a pretty penny for the experience, but I don’t want to go through it again.”

Much of the time spent working in an ER is boring and mundane but every shift has at least one patient that stands out and many shifts are filled with them. Through the tragedies, the deep sadness, the frustration, the funny times and the strangeness that happens, it was the best job ever to me.