Cinnamon, Spice, and Everything Nice

She runs right into me. "I was cooking!" she squeaks. "Cinnamon sugar sticks!" the words melt together, sticky and sweet.
I lean in toward her and inhale, "Mmm...you smell like cinnamon." She squeals in delight.
"You smell like chocolate," she tells me.
"I do?" I smile and tilt my head.
"No." She presses her little face into my shirt and rethinks. "You smell like oatmeal."
"Really?" I ask, thinking oatmeal's not a bad thing to smell like. Oatmeal smells nice and warm. Oatmeal smells like home.
"Maybe there's chocolate in your brain?" she giggles.
"In my brain?" I tease, "I would sure have to love chocolate a lot for it to be in my brain!"
"Maybe there's chocolate in your nose?" She can't stop laughing.
"My nose?! Why would there be chocolate in my nose?!"
"Guess what's in my nose?" she asks.
"I don't know. What's in your nose?"
She climbs into my lap, cups her hands around her mouth, and leans in to my ear to whisper "boogers" before rolling on the floor with laughter. And it's is sticky and sweet and nice and warm.

Mother's Day

There’s a boy. He’s stuck in bed— a giant tumor stuck in his brain, mom stuck by his side. He is sick and swollen. There will be no healing happening here, just so you know. No miraculous recovery. I’m doing what I can to keep him comfortable as his mom watches on, aging exponentially, gray and tired beyond her years. In the evening, the room is tense, brows furrowed, jaws clenched, air heavy. But during the deepest part of the night, it’s different. The boy sleeps soundly in bed, his mom sleeps soundly on the couch, and I stand in the space between. Her mouth blooms into a smile as she slumbers. She giggles like a girl, soft and carefree. The boy answers with a smile, exhales peaceful and easy with a low laugh. This continues, the love and happiness flowing between them like a conversation without words, like an understood embrace, like a breeze, like music, like light. I hold my breath and stay very still, willing some of this goodness to stick to me as it passes through. He died on mother’s day. I hold my breath and stay very still, willing all the goodness of the world for his mother.

Making Music

He drums his fingers on my arm
Like he's playing a song
His breath, the notes
Go on until they don't

Easy Come, Easy Go

His skinny legs strut around the floor like he owns the place. His bald head sticks out of his dark blue hospital gown, which billows like a cape as he runs down the hall. His IV pole rattles on, wheels wobbly, tired of moonlighting as a skateboard. He does a killer rendition of a Hannah Montana song. He uses both hands to plug his ears when I try to sing along. He break dances without missing a beat, between lines coming out of his chest and tubes coming from each kidney. He had a bone marrow transplant last summer. That was then. Now he's quiet. He sleeps. His gown doesn't billow. His IV pole is still. The doctors read his latest scan. It's not good. They've found tumors in his leg, his belly, the bottom of his brain. His mom cries. He comforts her, "don't worry mom," he says, "tumors come and go." He's 7 years old. He fills my heart and breaks it.

Failure

My first month at this job, I took care of a girl getting a bone marrow transplant. She developed graft vs. host disease, and her body, trying to defend itself, began attacking the foreign marrow. A year and a half later her body is swollen and her skin is dark; she is completely unrecognizable. Her liver has given up, causing inconsolable itching. Her kidneys have quit, causing excess fluid to pool around her heart and lungs. She can't talk. She struggles to breathe. She moans in her sleep. Her end is miserable. Her body has failed her. And even though I know it's not true, I can't help but feel I have failed her, too.

And It's Beginning To Snow

She has acute myelogenic lymphoma. She came to New York from Nigeria for a chance. She flew here with a blood count so low, it's surprising she didn't bleed out on the plane. The first night I took care of her, she pleaded "God help me, God help me, God help me, God help me" over and over again in a dark and strange room to a cold and un-answering ceiling, with only me to hold her hand as she threw up over and over again. She had a central line placed. She received chemotherapy. She lost her hair. Every last strand. She has had pain buckle her knees and take her breath away. But tonight, in the middle of this foreign place so far from home, she saw snow for the first time. And her eyes lit up like little moons.

Things That Go Beep in the Night

This little one is 7 days old. She has retinoblastoma. She is the first child of a loving couple. The first grandchild of loving grandparents. I am tip-toe over her tiny little crib, bent over her tiny little body, trying my best to reposition and re-tape her tiny little IV with what suddenly seem like giant hands. The fluorescent light above her bed shines harshly. She starts crying that newborn meow; her monitor alarms; her IV beeps, beeps, beeps in a cacophony of sounds that could drive the sanest person crazy. Her mother shouts at me to make it stop and then starts to cry. She is tired and angry and scared, and probably some other emotions for which no words exist, some emotions I have yet to personally meet. Because none of this makes any sense: it shouldn't be this bright while you're trying to sleep, it shouldn't be this loud this late at night, and newborn daughters should not have cancer. I agree.

Gone

Bone marrow transplants are risky. We know that. She was fragile to begin with. We know that, too. Now she's gone, and no amount of knowledge makes it any easier.

New Year's Resolution

I am spending New Year's Eve with my patient and his family: mami, papi, hermana, primos, abuela- they are all here. He has ALL which has been complicated by liver failure. He was unable to complete treatment last year. Now he's back, and it's good to see him, though I wish it were under different circumstances. When the ball drops, his family embraces me without hesitation. Prospero Año Nuevo! Hugs, kisses, and tears weave me in, part of the family. I ask my patient if he has any New Year's resolutions. Remission, he answers. I smile as shiny confetti floats to the floor. That's going to be a tough one to keep.