Atina! Stop shredding your bed! Atina! You can’t have chocolate! You’re a dog! Chocolate is NOT good for doggies! Atina! Get that goddam wet ball out of my face! Atina! SHUT THE FUCK UP!!!
Sigh.
Last night was a total wreck. For some reason Atina spent her night growling, woofing, and outright barking, at something that I could not see.
We are in a well-lit campground, so if there was, like, a bear strolling around, or a bull moose, or a hedgehog, I’m certain I would see it.
Maybe it was some perv hiding behind a tree, whacking off. All night. Sheesh.
On this premise, I chalked Half #1 of the night up to Virtuous Vigilance on the part of the Pup. But when Night Half #2 rolled wearily around, I got cranky. I shushed. I gave orders. I YELLED. I cursed.
As grey dawn faded into a grey rainy morning, I felt worse and worse. If there’s one thing that kicks me right out of orbit, mentally and physically, it’s sleep deprivation.
And of course my baby still needed her walkies, and breakfast, and more walkies, and playtime…And I needed large quantities of thick coffee, and something to force into my queasy stomach so I could take my pills, and I needed to use the bathroom, and brush my teeth, and put on clothes…And Atina, none the worse for her own sleepless night (who knows, maybe 🐶 s only take 😸 naps anyway…), was red hot and rarin’ to go, while I was dragging serious ass.
I got to feeling cross and cheated and just plain ill-tempered, and then I thought about something that happened, and my mind changed.
Here is what happened.
1989. I was pulling a two-week stint in the Pediatric Intensive Care Unit–the PICU.
My residency program was working us like slaves because we were down four warm bodies. One, my sweet ward partner, died in a car crash. One got meningitis from a kid she was treating. One got hepatitis from her dear boyfriend when he got back from India. And one was on a sort of permanent leave, because he had miscalculated a chemotherapy dose and the child died.
So the house staff were stretched much thinner than usual. Instead of every third or fourth night call, we were on every-other or every-every night.
In the PICU we usually did every-other-night, actually 24 hours on, 24 off. But since we were so badly strapped for staff, the PICU director came up with a brilliant plan: he would live in the PICU for two weeks, and I would live in the PICU for the next two weeks, and then we’d switch off again for another month. That way we’d both get to see our families, for the two weeks we’d be off. And of course if things were slow, our families could come and visit us in the call room, which was an 8 x10 ft luxurious affair made of beige-painted cinderblock, with a tiny bedside table to hold up the phone, and a worn metal chair.
When you switched off the overhead fluorescent lights, you were instantly plunged into darkness. Fortunately, every doctor carries a penlight, so at least you could find the bed, if you ever got a chance to actually lie down.
Hypervigilance is a common symptom of PTSD. Therefore, since half of my consciousness was always scanning the PICU for problems, I never really got to sleep.
One night when we had a truly puzzling and terribly critical case on the unit, I lay staring into the velvety black of the call room. Everything had been taken care of, rounds, orders, and the nurses were wonderful and right on top of things; so there was no reason not to catch a few winks.
But I was in the grip of free-floating anxiety, so I felt my way along the wall until I found the light switch, and lacing up my Rockports, I sidled out into the unit.
We’d received a case that day that came in via the ER. It was a little three year old boy, who presented with a high fever and blueberry muffin looking rash. I mean really, he looked like a blueberry muffin. But unlike muffins, which are good, he was not good. He was in very bad shape. Septic shock of some kind. Our usual tests could not detect the pathogen, or anything that could have caused his condition. This was 1989, remember. We’ve learned a lot since then.
We ran through every possible infectious disease that we knew about, and every form of toxic ingestion or exposure, and every possible cause of bleeding and organ failure, but nothing came out positive.
So we did the only thing we could do: we put the little guy on life support, gave him fluids and antibiotics and steroids, and prayed that with supportive care, his body would come through whatever it was, and heal itself.
This was not to be.
Even with maximal supportive care, his body deteriorated. He had been unconscious when he came in, and never opened his eyes or gave any indication of awareness. His kidneys stopped working, and fluid was backing up into his organs and tissues. We tried our hardest to keep up with that too, but soon it was clear that this little boy was not going to make it.
I can’t remember who we were waiting for. His mother had died, I remember that. It was just his father alone who took care of him. We must have been waiting for someone else…to be there…when we took him off the vent.
As I turned the corner from my call room to the unit, I saw the boy’s father sitting on a hard chair, his knees up against the bed, stroking his little boy’s swollen hand and weeping, his shoulders heaving.
I laid my hand gently on his shoulder and said nothing, waiting.
“Yesterday,” the father sobbed, “He was running around making so much noise, I told him to shut up…Oh, if he would only make that much noise again!”
Originally posted on 
