“Could be stress-related hyperglycemia,” I offer.“But I’d like to run a hemoglobin A1C test to see her longer-term average.If she’s still in the sevens, we might need to reassess her meal planning and education.”
He nods.Like I passed some invisible test, and then his pager goes off.He glances down at the screen.My heart races.
“Emergency.”He looks back up at me.“Let’s go.”
We head to the critical care area, the air immediately thicker with urgency.I fall into step beside him as a nurse rushes past, calling out details.
“Peds case, six months old.Cyanotic episodes, low oxygen sats… mid-70s.Fatigue.Parents report poor feeding, but no weight gain since two-month checkup.”
My heart thuds as we approach the bed where the baby lies in the crib.The parents stand on the side, mom’s hand on the baby, dad’s hand on her shoulder.I start thinking… respiratory distress, or even sepsis.
I glance at Brant just in time to see the way his jaw clenches, his body going rigid as he starts asking the parents questions.“When did the symptoms start?Any history of murmurs?Did the pediatrician mention anything unusual before this?”
He’s flipping through the chart while I check the baby’s respiratory effort, which is shallow and fast.I see the bluish tint around the lips and fingers.Oxygen’s already running, but the baby’s still struggling.This is bad.But I’m calm when I adjust the oxygen mask.
“Failure to thrive,” I whisper, almost to myself.“Could be an AV canal defect.”
He looks up sharply.“Yes.Order an echocardiogram.Get a pediatric cardiologist paged now.”
I nod, and the parents step aside while I call it in, hands already moving, brain spinning.I rattle off the orders to the nurse, who nods and moves quickly.Going back to monitor the baby, I count the respiratory rate.Hang in there little one.
“Pulmonary overcirculation,” Brant mutters.“Crackles in the lungs.He’s already going into early heart failure.”
My heart breaks for the parents who are watching us.Both look like they’re struggling to hold themselves together.
The on-call cardiologist, Dr.Sullivan, arrives within five minutes, and we step back to give him room.Brant stays close, and I watch from behind him.Both of us stare at the screen as the images flicker, and that’s when we see it.
The cardiologist gives the official results.The baby has an atrioventricular canal defect.A large one.Surgery is the only option, and it's needed soon.
Brant is visibly shaking.He clutches the papers with white knuckles, and his eyes scan them like he’s trying to change the outcome.
I want to ask if he’s okay, but something holds me back.His shoulders are hunched, his jaw tight.Whatever he’s seeing in those results, it’s affecting him more than it should.I can tell now isn’t the time.
The mother sobs now, and the father’s tears silently drip down his face.Brant doesn’t rush them.He waits, lets them process, then explains the next steps.
“We’re going to do everything we can,” Brant says gently.“Your baby is in good hands.”
The mother nods, unable to speak.The father shakes Brant’s hand.
I glance at Brant.His focus hasn’t wavered once, and for the first time since this shift started, I realize: I’m not just observing anymore.I’m part of it.
We step out of the room to the nurses’ desk as Brant makes some calls.
Dr.Sullivan, the cardiothoracic surgeon, arrives with his team.
Brant turns to me.“I want you in the OR.This will be a good case to follow.”
“What?Don’t you need someone to cover the ward?”
“I have already called in another doctor to cover you.Stay with the patient,” he says.
“Are you coming in too?”
“No, but I need to talk to Dr.Sullivan before they go in.”He’s already pulling up scans on the tablet.“He will.It’ll be tight, but they’ll let you in.”
I nod slowly.“All right.”
I help hand off notes to the called in emergency doctor and step back when I hear Dr.Sullivan’s voice cut through the air.“Dr.Thomas.Let’s go.”
