Heart to Heart

This kid is 15 years old. Doctors told him for two years not to worry about his reoccurring rash. They gave him ointments and creams and sent him on his way. Turns out he has cancer. Oops. You can tell he’s a real badass around his friends, but he’s polite to me, even though I can hear him cursing under his breath in Spanish every now and then to his mother. He has a portacath in his chest, chemo infusing. It’s 3am and I need to draw blood from that port. Nothing’s coming. I’m struggling. I have him move his arms above his head. I have him hold his breath and cough. I have him lying on his side, upside down. I’ve used heparin and tPA (a super clot buster). I’m quickly running out of tricks. I look at him, obviously exasperated. If I don't get any blood return, I can't be certain placement is right. And if I can't be sure about the placement, I can't infuse the chemo. He knows if I can’t get any blood I will have to de-access his port and re-access him again. This involves a fairly large needle and is probably not something he looks forward to doing at all, let alone in the middle of the night, yet here we are. He throws his hands up, “my heart’s bein’ stingy with the blood,” he says, and I can’t tell if it’s a question or an explanation, but he smirks at me and I laugh. In this moment, there is nowhere else I’d rather be than with this kid, his stingy heart and his generous sense of humor.