By Lisa M. Belisle, MD
Originally published December 2000, Maine Times

As we spoke, the toddler chased dust bunnies from their hiding places udner the shiny hospital crib. Eighteen months old, her blue eyes and inquisitive fingers glanced over my coat pockets and stethoscope before resting on my shoes. I was a resident in Family Practice, and had been assigned the examination of “Kayla Marie,” newly admitted to the pediatric floor at Maine Medical Center. This was my final task before seeing my own children, after 36 hours away from them. Idly stroking Kayla’s hair, I felt my daughter’s locks shifting under my fingers.

Kayla was a typical baby, curious but sweet. She lived with her parents and older brother in a rural Maine town with trailer-dotted hillsides. Her mother spoke quietly of her perfect milestones — her early laugh and frequent smiles. She had rolled over at three months, crawled at nine months and walked at a year. Then she started vomiting.

The vomiting began after Christmas. Every morning, Kayla’s mother found her normally active baby retching and listless in her crib. Her Cheerios would sit untouched on her high chair as she spent hours curled on her mother’s lap. An experienced parent, Mom ascribed the symptoms to a viral illness. Her seven-year-old son and husband had complained of sore throats and congestion for the past few weeks. When Kayla stopped walking, and hadn’t started again for more than two weeks, her mother grew concerned.

Kayla’s inability to walk precipitated several visits to her doctor. Agreeing that this lethargy was likely related to a recent virus, he saw her twice before noticing a strange inequality between her baby blues. Shining a penlight into her eyes, the rural pediatrician saw that one pupil was much larger than the other. Also alarming was the size of her head, which had grown far out of proportion to the rest of her body. Kayla was referred immediately to the traveling brain scan, and just as quickly sent here — a large referral hospital in southern Maine — once the reason for her troubles became apparent.

Kayla was not walking because she had a tumor in her brain. As her mother continued the story, I listened with a clinician’s head and a mother’s heart. Dealing with the medical issues became more difficult as I struggled with a cold fear. This could be my daughter. I could be this mother.

A silent film wound its way through my consciousness. It starred my brown-haired daughter, Abigail, laughing her father’s arms, then playing with her brother Campbell under cloudless Maine skies. The scene shifted to show Abby vomiting, then wan and powerless as she lay in a brain scan, a tumor blossoming in her head.

A man in a red flannel shirt entered the room, interrupting my thoughts. His young face was drawn with worry and uncertainty. He was followed by a cowlicked grade-schooler. Kayla’s mother introduced the toddler’s father and brother. She updated them on our discussion as I watched the baby. Like a day-sailor tossed by gentle breezes, her body listed to one side, as if straining to uphold the weight of her overburdened skull.

Kayla let me examine her with little more than a whimper, lying on her mother’s lap as I palpated her soft belly. Remembering my daughter’s response to similar exams, I mourned her apathy. Her mother’s eyes were distant, as she played her own silent films within. Before leaving, I thanked the family for their patience. They shook my hands with a grace belying the pain of their circumstances, and watched as I walked down the brightly painted hall.

I completed my administrative work and pulled on my overcoat. It was my last day on Pediatrics and I wanted to go home. Mud scented breezes met me at the hospital entrance, reminding me that my husband’s spring birthday was near. I had been awake for a day-and-a-half, and the fatigue clouding my head fed off the increasing ache of my heart. That could have been my baby. Kayla could have been my daughter.

I thought of Kayla’s family perched uncomfortably on institutional furniture, waiting for the brain surgeon and cancer specialist to carve up their daughter’s care: Tests, knives and medications creating a new rhythm to their days. I saw Mom missing the solitude of her morning coffee and newspaper; Dad pulled from his paper mill job.

Trained to be objective and distant, I could muster neither defense. I wept for Kayla’s family, and for my selfishness — my overwhelming relief that this was not my baby. I gave silent thanks to whatever twist of fate had allowed my children to thrive while another fell ill. My heart went out to the parents of Kayla Marie.

I cried for the baby chasing dust bunnies across the floor.