“Hi, Marisol,” I said, hesitantly sidling up to her bedside. “My name’s Angie. I’ll be helping to take care of you.”
Marisol didn’t track me. This close, I could hear the rattle of her breath. I pulled out my stethoscope.
“Need me to help you lift her up?” Mercedes said. “So you can listen to her lungs.”
I nodded, and Mercedes quickly hoisted her child into her arms. Marisol made a keening animal noise in complaint, her first real sign of life. Mercedes’s eyes flickered to mine then—kind still, but defiant, the battle-ready look of a mother who has had to prove her daughter’s humanity over and over again. I knew then that I’d been caught. I didn’t know what to do with Marisol, how to interact with her, and it showed in my awkward, stilted movements, my furtive glances back at Mercedes, my hesitance to touch her.
My next movements were more decisive. I lifted the back of Marisol’s shirt in a clean, clinical sweep. Her skin was tawny brown and perfect, marred only by the raised line of the surgical scar down the middle of her back. I placed my stethoscope to her back and listened, trying to isolate the staccato of her upper airway from the sound of air moving through her lungs.
“She does have crackles on the right,” I surmised after a moment of careful listening.
Mercedes looked satisfied.
“Yeah, your resident thought so too.”
She placed her daughter back into bed so I could finish the exam, and I checked her gastrostomy tube site, looked at the rest of her skin for cuts or bruises, tried my best to look into her mouth （she didn’t like that）， and called that a day on my exam.
Marisol had been in a hospital a total of 788 days （“But who’s counting?” Mercedes said） since her birth. When she was well, she was a delight. Being mostly nonverbal didn’t stop her from attempting to sing along to her favorite song, “Call Me Maybe” by Carly Rae Jepsen, or pulling pranks on her older brother. When she was sick, well. She was like this. She didn’t take any food by mouth. Attempts to overcome her oral aversion in her infancy had been thwarted by her Marisol-level stubbornness, and it had taken a year to find a feeding tube formula that she could tolerate. Because of this, she’d never learned how to swallow. Her baby cousins didn’t understand that, especially three-year-old Sammy, who had only wanted to share his birthday cake and thought the best way to do it was to slam a chunk of it into Marisol’s mouth. The cake had most likely gone down the wrong pipe, considering her tenuous oxygen saturation levels and the presence of crackles in her right lower lung fields. Many efforts were under way to help her cough out the offending particles, including chest physiotherapy and all sorts of nebulizers. She was also on antibiotics.
“Good,” Dr. Berber said after I finished my presentation. Then he turned into the room without pimping me at all.
“Wow,” I mouthed to the open air, and trudged into the room after him.
Eight
Marisol did get better quickly. Aspiration pneumonitis, Shruti called it, and I scrawled that in a corner of my notes because until that moment, I hadn’t known pneumonitis was a thing. Dr. Berber switched off service and Dr. Mallort, whose questions I actually understood, came on. I spent the next few days presenting patients, studying for my pediatrics shelf, ignoring my parents’ phone calls, and parsing through studies for my literature review. I got a little bit better at being a peds third-year student, a little more helpful, a little less annoying. Shruti called me by my name.
I got comfortable, and I forgot to watch my back.
We could hear Marisol’s laughter from outside the door. After four days of treatment, she had perked up considerably, an impressive improvement, considering we’d been throwing around the concept of intubation* when she was first admitted. Marisol laughed at most things, though, and so I didn’t think much of it, until my feet crossed the threshold of the room and I heard his voice.
Of course, there Ricky was, sitting in a chair across from Marisol, paintbrush in hand, finishing off what appeared to be a pink butterfly on her cheek. Doing his job. Volunteering for Child Life, like the saint he was pretending to be. Looking, to my chagrin, very good in his paint-splattered white T-shirt and jeans. And Marisol was beaming at him like he was the most interesting, amazing person in the world. My wretched loser heart still skipped a beat.
“Hey, team,” Mercedes said, blissfully unaware of my internal conflict. Ricky turned to glance at us, then did a double take. I shrugged his way, keeping my eyes pointedly on Dr. Mallort and Marisol as I presented her case. I could feel Ricky staring, like he always did when we ran into each other. Didn’t his grandma teach him better? Still, I talked through all the ways that Marisol had improved since admission, her rock-solid vitals, and ended with “I think she’s ready for discharge today,” without breaking a sweat.