The MIA Parent

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In hushed voices, I heard them. The seven-year-old boy stood, still in full practice hockey gear, hockey helmet pressed against the window of the double doors, waiting for an adult to arrive. “His mom is never here, poor thing.” came one hushed whisper. “If I knew which bag was his, I’d help him change myself!” came the hushed response back.

This parent thing is a hustle, isn’t it? Making it on time to this hockey practice, to this football game, to gymnastics practice. Remembering to pack a cardboard cereal box for the next school project, remembering to buy Valentine’s cards for the school Valentine’s party. Remembering to sign permission slips and pay for the school party. RSVP’ing to your son’s school friend’s birthday party, then hurrying to the store the day before to buy a birthday gift. Not forgetting to pack the mid-morning school snack when packing the lunch you made last night. Buying the right dance shoes for your daughter’s dance competitions. Getting new skates for your son’s growing feet. New snow pants for your seven-year-old daughter that has been squeezing into too tight pants for an embarrassingly long amount of time. Having dinner ready. Making sure your kids have their shoes and boots for school. And a hat. And gloves. Lining up all drop-offs and pick-ups so your kids are never the late ones or the last ones to get picked up.

Maybe your hustle looks different than my hustle, but it is all in the wizadry of scheduling and mental notes floating in our minds when it all falls into place day after day after day.

Listening to those moms at that hockey practice, I felt a pang in my heart. I felt a pang in my heart for the multitude of times I was that MIA mom. When I am that mom that cannot drop off and pick up my daughter at dance practice. When I cannot stay and watch my son play football. When I cannot be the one to pick them up or drop them off at school. When I could not be there at their 1st grade winter party. That time I almost missed my 3-year-old’s first daycare program and nearly broke my back figuring out a way to make it there.

That MIA mom has been me time and time again. But I do want to make one thing clear. I am not always there, but I am always there. I packed the snack in my daughter’s dance bag, I counted her shoes to make sure she had her jazz, ballet, tap shoes. I laid out those dance clothes you see her wearing. I made sure my son had his mouth guard, full water bottle, and flag football jersey and all flags accounted for and laid out on his bed before I left for work. I pre-prepare dinner for my kids, even when I cannot be there to eat with them. I laid out their boots, coats, hats, gloves in front of the garage door, I fastened their snowpants to their backpacks. I packed my daughter’s daycare pillow and blanket for naptime and hung it on the door. I hunted down the school library books in the darkness and jammed it into my son’s bookbag all before I hurried out the door for work at 6 am. You may not always see me, but I am always there.

My physical absence has no correlation with how much I care about my children. No matter where I am, my presence and heart are always with my family. All of our families look different. But the bottom line is that we cannot compare or judge one another by our outer appearances. We all have different capacities and priorities come in all different forms. They come in the form of work, in the form of aging parents, in the form of friends, in the form of spouses or single parenting, or other siblings. Everyone’s circus is made differently.

Two weeks ago, I was in Whistler, Canada with my husband. He was the chair of a conference, and I, along with friends, were along for the ski adventures that laid on those gorgeous mountains. I ran into a friend who asked me if this was the first time I had left my children behind for an extended period of time. It was not. I explained to her that while it was not without its flurry of emotions of guilt, anxiety, sadness to leave my children at home, it was also with excitement, happiness, and anticipation that I looked forward to dedicating undivided attention to my husband and friends. I explained that I felt it was healthy for my kids to realize that the world did not revolve around them. That I loved them intensely and loved spending as much time with them as possible, but I am also committed to tending to the other parts of my life that make my life full and make me a whole person. She tilted her head, mind blown, and said, “I’ve never thought about it that way.”

Sometimes it is out of our control. I have to go to work when I have to go to work. But sometimes, a night out or a weekend away is something worth prioritizing. The bottom line is my life revolves around my kids, but it also revolves around showing them the strength of who I am as an individual and reminding them that they are one part of a greater world around them.

I believe that we all want to be there for our kids, the best we can. The best we can sometimes means we are late to pick them up from hockey practice because their younger sibling has gymnastics practice across town that consistently runs late. The best we can might mean we have a baby-sitter take them to dance practice when I work predominately evenings. The best we can might mean we spend a weekend away with our spouse to care for our marriage. The best we can might mean clearing our day to volunteer at their 1st grade Valentine’s Day party. The best we can might mean saying no to a work meeting to be there for our daughter’s first dance competition.

Being the MIA mom does not mean you are not doing the best you can. I know that better than anyone. So, to that MIA hockey mom or dad. I see you and your presence in your son’s well-fitting hockey helmet, jersey, and skates. I know you are present and the best you can do with your circus is absolute perfection to me.


Grandpa by Claire

Grandpa hasn’t picked us up in a long time. When he gets done in the hospital I’m going to show him something. I wish it hasn’t been a long time.

These are the words my three-year-old said out of the blue tonight when I was tucking her in. A wave came over me; I sunk my face farther into her Lightning McQueen pillow and let my tears disappear into the red fabric underneath my cheek. I was thankful we were snuggling in the dark, crammed together in her toddler bed.

11 months ago when my father-in-law died, one of the things that brought me the greatest grief was the thought that my children’s memories of him would fade with time. Especially my youngest that adored her grandpa so much. My heart ached thinking that these memories of what Grandpa looked like, how Grandpa laughed, how Grandpa hugged would become blurrier and blurrier with time. As if with each year, we would lose more of him as the memories became more faint.

Out of the blue tonight, my youngest reminded me that Grandpa is still alive through her. The grief resurfaced from the undercurrents of the daily bustle. The waves stopped crashing and the wind settled, and the hollow that he left burned like fire.

I listened to her musings. The shadow of her face cast against the column of light that spilled through her cracked bedroom door. She looked so thoughtful as she pondered how long it had been since she had seen Grandpa. I wondered for a second if I should ask her what she was going to show Grandpa. But it was too beautiful and too heartbreaking of a moment; I decided to let my big-hearted three-year-old have that special moment with her grandpa to herself.

The holidays are nearing, and by nearing, I mean that we will be smacking face-first into them here as we turn the corner. It is a time when everything about the people you love is heightened. You are thrust together in a haphazardly coordinated fashion. You have idealistic expectations while simultaneously bracing yourself for the worst. You are excited to celebrate the best time of year with those that mean the most to you all the while knowing that they will likely get under your skin in 7 seconds flat. You have an idea which of your inadequacies will be immediately brought to your attention under the guise of “we’re just worried about you.” You will try to dart behind the children for distraction. Unless parenting is one of the points of criticism you are trying to deflect.

All cynicism and family dynamics aside, the holidays are a time of magic. Of festive lights brightening common, everyday fixtures. Of holiday stories, decorative cookies, and yearly traditions. It is a time to come together and celebrate and show with our own touch how we love those that we love most.

Unless someone we love most is no longer here. Then holidays become harder. Especially that first holiday without them. A void we never anticipated being part of the holidays sits loudly in the center of the room and throbs in our hearts. We see the joy of the holidays through a lens of aching—part of us remaining idly empty.   We move through the motions and we daydream about rewinding time to last holiday when the greatest stressor was what your inappropriate uncle was going to say in front of your kids. You crave being able to fret about the petty things that had occupied your thoughts, because that meant there were no waves of hollowness widely sweeping over you and making you gasp for air like there are now.

It is hard to feel festive when loneliness so definitively puts its arm around your shoulder. It is hard to let the excitement and joy win.

Tonight, I learned from my three-year-old. The best way to keep my father-in-law a part of our lives is to flood these holidays with his memories. To make him an integral part of our celebrations. To make sure he doesn’t fade in the eyes of our kids. To create new memories with the memories of him. This holiday, we won’t let the loneliness sidle up to us. We’ll inch it out with his presence in our hearts and in our traditions. Grandpa will be with us. And we will show him something over the holidays so it will not have been so long since we last saw him.


There was a moment three nights ago when I was plunging the kids bathroom toilet with all kinds of odors swirling around and splashes of unpleasantries splattering on my arms. I was still in my work scrubs. I had three little kids with wet, dripping, just-bathed hair half-dressed in pajamas, mesmerized by the grossness of what was unfolding, occasionally yelping at the top of their lungs when their feet got a drop of the “YUUUUCK!!!!!”  “Get back”, I mustered to meekly say to them.  That was the moment three nights ago that I just felt ready to collapse.  It was the moment of the day.  “You can’t do this.  You need to go to sleep.”  Is what my brain and body ached and pleaded.  But I was the one for the job, and by the one–I mean, the only one.  So I unclogged the toilet, helped dry my kids’ hair, and got them ready and in bed.  I was ready for bed myself, but Laundry.

There was a moment four nights ago when a patient was unresponsive and I wasn’t sure she was going to make it.  Another patient was on the brink of going into liver failure and was refusing life-saving medications.  Another patient had an infection spreading up his above the knee amputation and was at risk for losing more of his leg.  Along with all other patients in the department that had been impatiently and patiently waiting for hours.  It was the moment of the day.  I was the one for the job.  So I worked with my team to stabilize my patient, I talked to my other patient about the importance of continuing her medications, I started my third patient on antibiotics, and I kept moving as fast as possible.

There was a moment two nights ago when I had gotten home from work–I was so relieved to finally have my husband back in town after his week of travel and ready to finally have a day off.  It was the last night my parents were in town, and all I wanted to do was enjoy a night of nothing but just being together with everyone I loved most in my life.  And then I got the message that I was needed the next day on my day off to cover a morning shift.  My husband saw the sleepless stress brimming in my eyes, and quickly said he would take care of the kids and take my parents to the airport.  There was a pit in my stomach as we moved through the rest of our night.  I wasn’t ready to say good-bye to my parents just yet.  And then there was the moment. Except this time, I just couldn’t anymore. There we were, brushing the kids teeth and putting on pajamas–“I got this”, I cheerleaded myself. But then the tears started in my gut and like unstoppable soldiers marching steadily to battle, they rose in my chest, into my throat, and poured out.  My husband held me, and I just couldn’t stop.  My 6-year-olds slowed their teeth brushing strokes, and my 3-year-old instinctively walked between my legs and hugged me, “It’s okay, mommy.” I heard her say.  I’m not sure she has seen me cry before.

There was a moment last night. I had been on call and had therefore scheduled a baby-sitter to help with the kids in case I got called in. I had yet to be called in and my husband had come home early for a dentist appointment. We decided to have a night to ourselves; I packed our work bags and our work-out bags and planned for a productive night of getting work done while just spending some uninterrupted time together. My husband picked me up and as we drove away, he asked me if instead, I wanted to go somewhere and watch the post-season Cubs baseball game, already in progress. Yes. This was for sure the more attractive option. So we drove to a local sports bar, ordered fried and cheesy appetizers and cheered, cheered for the Cubbies. No one else at the bar appeared to be a Cubs fan. So it was just the two of us, hooting, and hollering, yelling and high-fiving as the Cubs went on to win against the Nationals. It was a close game which made the victory that much sweeter. This was the moment. The moment when despite the rush, the pull, the overwhelming, we pushed it all aside for just a night cheering for our favorite team. We got home just in time to tuck the kids into bed. It was the highs of a perfectly ordinary night–the Reset that I needed.

There are moments that we barrel through because we are tough and we are strong and we can do it all.  There are moments when it all topples and no deep breathing can make it less overwhelming. There are moments when we remember that beneath it all, there is so much for which we are thankful. We are trying our best to do it all, but it is not easy and we just may be balancing between doing it all, hitting our breaking point, and finding the joy sprinkled through all of it.

Anytime anyone comments on how they think I have it all together, it makes me want to take a nap.  It is with every last fiber of muscle, every last brain cell, every last particle of stamina in my body that I try to pull and hold together this life of career and family and home.  And I know I do not stand alone.  That all you capable, multi-tasking parents out there are on my team.

The next time you are standing in your kids’ bathroom, whispering sweet nothings to plead your kids’ clogged toilet to flush, know that we stand together in willing for that sudden gush and swirl of the water in that toilet bowl so you can put that chapter behind you. Know that in that moment of nothing great, there will be moments of sheer happiness that will follow, and Reset us, until that toilet clogs again.

The Secret to Our Marriage

“What is the secret?  I feel like we are already failing.”

A close friend of mine that recently had her first born asked me what was the secret. What was the secret to getting through these tough years with a young family and coming out whole on the other side? How was it possible to maintain some semblance of your identity and maintain this relationship you had with your husband before these small, yet all-consuming little beings enveloped our lives? I sat for awhile, stumped by this question. I couldn’t fathom why she would be asking me. I felt I was still trying to pull myself out of the knee-deep sinkhole of parenthood, marriage, career, and just standing upright to do life every day. What was the secret. Was there a secret? For the first time in a very long while, I felt speechless. We walked away from the conversation, me feeling astounded that I didn’t have some know-it-all response, and my friend feeling defeated that I had no feel-good, sisterhood pep-talk to fill her hopeless vat of newborn, sleepless despair.

It’s such a cliche question, “What is the secret to marriage?” With so many knee-jerk cliche answers. “Never go to bed angry.” “She is always right.” “Happy wife, happy life.” “Communication.” Sure, sure. In the ideal world. All of these are the answers we should live by. But unfortunately, none of us live in this picture-perfect, well-rested ideal world we so easily tout about. We live in a world where our patience is worn down, our frustrations and irritations are threatening to erupt out of the running bath of bubbles, and we never feel quite on top of everything that demands our attention. It is exponentially easier to promise to “never go to bed angry” amidst the warm glow of a candle-lit wedding reception, sitting on satin-covered chairs, eating square pieces of marble cake with fluffy icing, than in the midst of real life with kids and careers and communities where it becomes much easier to stray from these words of cliche wisdom.

My husband and I fell in love when we were two college kids with nothing on our minds but finals and future dreams. We studied abroad together and followed one another around Barcelona. We studied in the library on campus and ate pop-tarts out of the package and ramen out of styrofoam bowls. We had great aspirations and all the time we wanted to dedicate to them. I remember being in graduate school on a warm, sunny day and driving the three and a half hours to New York City where my husband was in graduate school. I remember spending a Saturday in the longest post office line just waiting to deliver some boxes. I vividly remember that feeling that something so mundane and seemingly irritating was in fact enjoyable because here at my side was the person I loved.  I felt so lucky.

Fast forward through the years. We checked off college, then graduate school, then residency, then finding jobs, then saying “I do”, then buying a house, then starting our family. We would soon realize that through all of the obstacles, all of the setbacks, all of the losses, disappointments, proud moments, the most intense would be the raising of a family. There was absolutely nothing quite like taking care of twin newborns through days upon weeks of sleep deprivation. No 30 hour shift in residency, no marathon all-nighter studying in graduate school could compare. No, the sleep deprivation of newborns was epically unparalleled. We stumbled our way through it. We took turns, we did it together, we stepped up when the other was crumbling. There was no science, there was no set of rules to follow. We just took it as it came and barreled through. And somehow, we came out on the other side still a team.

Fast forward every day of every year since we had our twins, then our third child, and it has been much of the same–though I am happy to report, the increments of sleep have become appreciably greater. Every day, every week seems like a two person relay where we alternate sprinting legs of the race and work so insanely hard at optimizing a seamless transfer of the baton that doesn’t end in a falter, a loss of stride, or worse, a drop of the baton or disqualification. The load becomes greater with each year. We add demanding careers, community responsibilities, kids’ school obligations, kids’ activities, taking care of extended family, the maintaining of a house, and the weight of the load becomes harder to toss between the two of us. The mere organizing of a week of schedules–who needs to be where when, who is working, who is out-of-town, who will be picking up/dropping off/staying with our kids feels like the putting together of a 1,000 piece jigsaw puzzle that needs putting together week after week. We scramble to organize the chaos and stay on top of it, but it seeps at the seams and sifts through our fingertips.

We are so tirelessly tired. We often feel like hollowed-out shells of those two lovebirds that followed one another around Barcelona. But as we find ourselves still knee-deep in these trenches, we do as we always do. We pass it back and forth. We lean on one another.  We do it together. We do it with respect and with humor. We stand strong when the other falters. We take on one another’s priorities as our own. We remember that the emotions that resound at times when we lack sleep, when we are stretched our thinnest, when we are at our most stressed are not the emotions that are truly beneath it all.  We appreciate one another and know we are both giving it our all.

This past weekend was my husband’s birthday. I packed the weekend full of birthday celebrations. In the middle of it all, I planned a dinner for the two of us and an overnight stay away from home. In that short, less than 24 hours away, we were reminded of us. We let those daily strains and stretches slough to the side and just remembered that at the real center of it all is still just the two of us. And while we stood in that bustling line waiting to order our coffee on that Sunday morning, I was transported back to that long post office line. Here I still was, enjoying a mundane wait in line, because here at my side, was still this person I loved. I feel so lucky.

I can’t say I know the secret to marriage. Those that have been married 25 years, 35 years, 45 years may hold the secret, but all I know is what has carried us through these tough first years as a young family of five. We stick together. We stick together in our unified voice as parents. We stick together in taking care of our family and friends. We stick together in how we prioritize our careers, families, and each other. We are an eternal team. And while we are never perfect, and are still at the beginning of this long relay run, we will keep passing the baton back and forth the best we can.

Raising of Human Beings

It started with a lanky 6-year-old that had no interest in learning to swing. He sat on the swing and his legs dangled like two lackadaisical twigs in the stagnant humidity of summer. His twin sister next to him pumped her legs and swang high into the sky, back and forth, higher and higher, her long brown hair whipping behind her and across her face. I couldn’t quite put my finger on it. I wasn’t sure if he truly just couldn’t figure out how to swing or if he just had no interest. Both my husband and I would both go through painfully detailed tutorials with him: you lean back, you straighten out your legs, you lean forward, you pull your legs back . . . He kicked and flitted, and remained dangling upright. He’d quickly lose interest and tackle the next adventure.

I suppose it was okay when he was four. And five. But now it was summer and he was six. It should be part of the 6-year-old experience to feel that wind whirling by your ears, that weightless tingling sensation in your stomach as the swing swung low, the lightness of flight as the swing swung high.  While this certainly wasn’t the end all be all milestone of a 6-year-old, it was time to try a different angle. This is how we came up with the ingenious idea of making it a competition. Our kids, and let’s be honest, my husband and Ihave a bit of a competitive fire in our hearts. Make something into a competition, and we will roll up our sleeves and dive in.

Here were the terms we set forth at the beginning of the summer:
By the end of the summer, my son needed to learn to swing and I needed to learn to do a headstand. Best one to complete their goal got to plan the date of their choice for the two of us.
My husband and 6-year-old daughter made a similar bet. They both needed to learn to braid hair. Best hair braided at the end of the summer got to plan the date.

The competition was on. All summer, it was a fun, energetic banter as we “competed” to perfect our end goals. By the end of the summer, my son was soaring high on the swing and both my husband and daughter had mastered the art of the braid. My headstand was a little shaky, but my feet were up in the air and that was good enough for me.

We allowed my parents to judge our competitions and I should have known their grandparent-biased would throw the results. Both my son and daughter won the competition. It was a clean sweep by the 6-year-olds.

The summer was over well before a blink of anyone’s eye, and the grand prize of an end-of-summer date never happened before we rolled into the school year. We promised them up and down that the first Friday after school started would be our date night. It was in fact the only free weekend night we had for the month of September.  That entire first week of school, they could hardly contain themselves, planning their dates, changing their minds over and over. My relentless persistence even paid off as my son carved a stop at Starbucks into our date night. Friday came and that morning started with every light switch in the house seemingly flipped on. “Happy Date Friday, Mommy!!!” The kids bounced about their morning in anticipation for the end of the school day.

Two hours into their school day, I got a message that my mother-in-law was feeling short of breath. She was going to the emergency department. I was car-less at the moment–my parents were visiting and out buying every bulk package at Costco they could possibly fit in my minivan. My husband had left work and was on the way to the hospital to make sure my mother-in-law was okay. Ultimately, my mother-in-law was admitted to the hospital. I thought about the rest of our weekend. I worked the rest of the weekend evenings, and the mornings were inundated with kids’ activities. Every slot of time was spoken for. I thought about how it was important for us to go visit my mother-in-law and important for the kids to go visit her and show their support and love for her. I thought about this sacred Friday night that was the culmination of a summer’s worth of teasing, afternoons spent practicing swinging, and mornings spent biting my lip as my daughter doused my hair in water and pulled and knotted it into braids. I thought about their little bodies buzzing with anticipation. I thought about their longing for alone time with their parents.

As a parent, a piece of your heart aches deeply when your child experiences disappointment. Your natural instinct is to shield them with bubble wrap to protect them from the crash. Your natural instinct is to leap forward onto that mud hole so they don’t stumble and land face first in wet, cold, sticky dirt. Your natural instinct is to try to hold up the dam and patch the holes before the big cartoon tears start to spurt out of the corners of their eyes. But what do we do when we shield them from disappointment? We raise children that miss an opportunity to learn to cope. To learn to encounter deflation and devastation and realize that on the other side of that is healing and acceptance. We raise children with the attitude that everything goes “right” and will easily fall into place with no understanding of the brick walls that will hit them in the face even when they do everything they are supposed to do and swing as high as they can and braid as nicely as they have been practicing to do.

Disappointment is just a part of reality. And it hit me that perhaps I was approaching this all wrong. All this time, I have been working so hard to raise these children. All this time, I have been trying to create fun and memories and hit milestones. What I really want, is to raise human beings. Human beings that put fun and prizes aside to be there for their family when they are needed. Who learn the importance of dropping everything and seeing their grandma in the hospital when she is sick. Even if it is just to sit at her bedside and eat a meal with her. That even though, this Friday date was the culmination of summer and the most important thing they had in their 6-year-old lives, there is absolutely nothing more important than family and being there for one another.

I thought about how to address this when I picked them up from school. I knew that they would be enveloped in the heaviness of disappointment that made my every maternal instinct cramp. But facing and coping with disappointment is also part of the raising of a human being.

We set down our backpacks and sat on the family room floor. I have something to talk to you about. I said. Grandma was having a hard time breathing today, so she went to the hospital and they decided to keep her there tonight so they could help her breathe better. We talked about being sick and how that felt. We talked about being alone and sick and how that must feel. We talked about being sick, alone, and in a hospital bed and how that must feel. We talked about how if they were sick, they probably wouldn’t want everyone in their family to leave them by themselves in a foreign place and go out and have a really great time. We talked about the importance of being there for family and putting everything else aside. We talked about putting our date on hold and going to see grandma in the hospital.

My daughter looked at me. Her face fell for a transient second. You probably wouldn’t even catch her reaction if you didn’t look closely because it was quickly replaced with a bright smile and a nod. This is how she responds. My son broke out into immediate tears. His cheeks got flushed. His whole body became hot and sweaty, and he crumbled into me with large heaves. This is disappointment, and this is how my 6-year-olds express it differently. We talked through their feelings. Their reactions. That disappointments are tough and both their reactions are valid. We talked about how each setback and how we react and move forward will help us the next time.

I allowed them their time to process. And when they felt better, they both knew that it really just came down to family.

That night, we spent in a hospital room. The kids ate their dinners with french fries with full kid-energy and kid-joy. They bounced around grandma’s big hospital room. They gave her hugs, lifted her spirits, and they let us tickle them until they were full on squealing. We left after a full night of being together and the night ended the same as if we had gone one our date nights—with exhausted kids asleep in the van from another full night.

And that’s how I came to realize that in the day-to-day choices we make in raising our children, we are ultimately raising human beings.

Imagine Her Story

Imagine being 31. Imagine being diagnosed with cancer. Imagine it spreading and taking over your body. Imagine going to one of the best hospitals in the nation filled with hope. Trying one chemotherapy regimen. And then the next. And then the next. And then the next. Imagine your body and your cancer rejecting all of them and running out of options. Imagine your doctors—experts in their field and your final hope—telling you that the medicine is making you too sick and isn’t working. The cancer is progressing. Imagine having fought enough battles for a lifetime. Imagine realizing that the cancer has outrun your race. Imagine knowing that time is running out. Imagine knowing that it is time to count the weeks and hope for months.

Imagine being divorced. Having two kids under the age of 8. Imagine your ex-husband moving to another state. Imagine being the backbone of your family of three.

Imagine being so gripped with pain that you cannot eat. You cannot think. You cannot function. You cannot sleep.

Now imagine it all: Being 31 with lung cancer that has spread all over your body that pulses with pain. Being told that it was time to plan your final days and not knowing how to tell your kids as a single parent.

Can you imagine? It cripples me to do so.

But I opened the door and I didn’t just imagine it, I met her. This was her story. Matter-of-fact. Her eyes steadied on mine. Every muscle relaxed.

She had a plan. In three days, she was flying back to her home country. She was leaving this life before it could leave her. I don’t pretend to know the path she has walked to come to this decision, with her bags packed on the side, ready to step away on these legs that have stood steady when every corner has closed in on her.

I flipped through page after page of medical records. I read about her pain. I read about her decline. I read about the age of her children. I read about her ex-husband living states away. I read about how her parents were deceased. I didn’t ask too many questions. This was not the time for too many questions.

I begged her to stay in the hospital. Her physical pain was too great to handle alone. Her pain was something we could help her with. She couldn’t just step away just yet. It wasn’t time to be alone. I circled back to her room in our Emergency Department three times. The third time, she nodded her head.

Today she should have flown home, leaving her American life behind her. She is still in the hospital. I am another face in hundreds that crossed her path in this final fleeting countdown that no one should have to imagine. I know she won’t have long, but that should not stop us from being her advocate. Every day she continues is another day we continue to treat her however we can. She may be living by the day, but we will be alongside her to re-invision these unimaginable days.

Blink. Reset.

It is one of those nondescript 7 a.m. work days when you feel as if everyone around you is still waking up.  Still with half of their first cup of coffee to drink; the caffeine not quite kick-starting their day just yet.

Yesterday’s loose documents still being filed.  Nurses amidst their morning hand-offs at change of shift.  Morning huddle circles just starting to materialize.

The ambulance phone rings, piercing this morning hum.  78-year-old-man with dizziness.  Vital signs stable.  ETA less than 5 minutes.

He arrives.  He is vague about what brought him to our emergency department ambulance bay, but he is certain of his diagnosis.  This dizziness–just like the vertigo that brought him here 2 years ago.  This left arm pain–just like the pain from the left arm surgery 6 years ago.  This heart burn pain.

“Well, sir, what does your heart burn pain feel like?”  He tells me it is a pressure.  A heaviness sitting on the middle of his chest.  I ask him about the left arm pain.  It is an ache that has made a resurgence after 6 years of not having pain since his left arm surgery.  He describes it as an ache that has become progressively more prominent since its arrival three days ago.

The lackadaisical air of this morning quickly lifts, and I swiftly start undressing my patient.  “EKG.  I need an EKG.”  And the EKG confirms it.  “Well, sir, I am glad you decided to come in today.  You are having a heart attack.”

His wife is now sitting in a chair next to him.  They both look at me, bewildered.  The patient looks as if I have popped out of the closest shrub and startled him, “I am?”  His wife is overcome by an immediate shadow of grief and panic that settles onto her shoulders, gripping her with a paralyzing tremor, the way a strong, unexpected gust of wind shakes a trembling leaf holding tightly onto its last life-line branch.  Tears storm into her eyes, as her breaths become shallow and uneven.

I explain to them next steps.  I describe the commotion that will quickly envelop them, about the events that will unfold before their eyes quicker than it takes to process each and every one.  I assure them that they are in the right place.

They nod.  I linger.  I am confident it will be okay; I want them to feel my confidence.

Minutes fly like hummingbird wings.  Orders are written.  Medications are given, and my patient is ready to be taken to the cardiac suite.  I have no doubt this transfer will happen swiftly and seamlessly.

The emergency department is starting to fill with other patients:  The patient with foot pain in room 6.  The patient with a headache in room 8.  The driver involved in a car accident in room 12.  The patient with nausea and vomiting in room 11.

Between every patient encounter, as I walk from room to room, I finish reviewing the plan of the person I have just seen.  I think about what they just told me, what I felt with my hands, what I observed with my eyes, what I smelled, what I heard, about how their family or friends reacted at the bedside.  I think about every single part and stop between rooms to finalize my orders for that patient.  Then I blink.  I reset.  I introduce my mind to the patient I am now going to see.  I think about the one word descriptor that pops up as to why they are here, I recite his or her name in my mind, I note his or her age; a laundry list of possibilities of what may be going on starts to populate in my mind.  I momentarily let go of the person I have just seen.  It is a quick, brisk walk from room to room, but it is the time I have.  I blink.  I reset.

The man four rooms down having a heart attack will not alter the attention I pay to the woman here who has had foot pain for a year.  The frustration my patient with foot pain relays who has felt bounced from specialist to specialist turns to impatience and anger  when I say I cannot guarantee I will find her answers today.  I will not allow this interaction to affect my patience and compassion for my next patient with a headache in room 8.  The severe pain of the patient with the headache will not make me think less of the neck pain my stoic patient in room 12 reports whose car was T-boned by an SUV going at highway speeds.  The stoicism of my patient in room 12 will not affect my sensitivity for the first time pregnant mom, tearful about her struggle to provide nutrition to her growing baby through her crippling morning sickness.

So, between rooms, I blink.  I reset.

As I move swiftly from my first patient having a heart attack to my patient with foot pain, I see out of the periphery of my vision my patient’s wife.  She is standing as close to the wall as possible as her husband is being transferred to a different bed.  She looks small.  Her eyes brimming with worry.

In that moment, I am transported back to my 17-year-old self.  My dad is back inside from a half-mowed lawn.  He is sweating cold sweat, pale, labored in his breathing.  “Call 911” he tells me.  “Call 911”, says the man who, in my 17 years of life had never complained about an achy joint.  “Call 911”, says the man who, when a cement brick fell on his left big toe, had unceremoniously poured betadine on it, wrapped it with a gauze, and returned to pushing a wheelbarrow full of bricks.

In a blur, the ambulance arrives, and is takes away my dad, lights and sirens.

My mom, our family matriarch, my pillar of strength, is left limp, helpless, frightened, sobbing.

I see my mom in my patient’s wife.  She carries herself differently, but I know there is panic, there is fear of the unknown. So, this time, I don’t blink.  I don’t reset.  I pause.

“He is in the best of hands.  I know it.” I hug her.  My stethoscope digs into my collar-bone, and likely hers too.  But we hold the embrace, we both squeeze a little tighter, and when we let go, she is still heavy-hearted, but there is something lighter in her eyes.  She looks less small.

He made it.  He’s alive.  He’s okay.  I checked in later in the day after his cardiac catheterization to re-open the blocked arteries around his heart.  He’s okay, and so is she.

I have to blink.  I have to reset.  But before I do, I want you to know, I am here for you.  And only you.  As long as you need me.  If you are the one waiting in the next room, please know, I’ll be there as soon as I can be, for as long as you need me too.

At the end of the day, no matter how many times I blink and reset, I’ll gather you all up, and carry you all home with me.  Because at the end of the day, it’s all of you that has made an impact on me.