I was finishing a consult for the PICU when they rushed her in. It’s never a good sign when the senior triage nurse doesn’t bother taking the baby out of the car seat before running them to the resuscitation bay. The parents follow silently behind, as grey with worry as their little girl is with shock. I slip in behind them and watch the controlled chaos unfold, this consult will be coming my way, after all. I take it in; nurses establishing IVs, RTs preparing the airway kit, the attending assessing her extremities – cold, poor cap refill. I haven’t been back at work very long; this scene is still too fresh. Deep slow breath.

A junior resident is standing at the periphery. She’s good, we’ve worked together a few times. “Grab me the ultrasound, please” I ask. She nods and runs off. I wait for an eternity, though it couldn’t be more than 60 seconds. She enters as the attending slides the tube through the cords. He calmy states his orders, “I need amp and gent, where are we on that fluid bolus?”, he’s well-seasoned, never loses his cool – I make a mental note to emulate his calm demeanor as I slide the probe between her tiny ribs looking for a window.

“She’s only 8 days old” I hear her mother choke out. The image slides into view. It’s barely recognizable as a heart. “Doctor” I say, loud enough to be heard over the beeping of machines, the back and forth of nursing orders. He looks toward the screen. “Good catch” he nods my way. “Get me cardiology” he barks out. “We need to start a prostaglandin infusion” I say to the nurse responsible for medications, my own heart pounding in my chest as I turn to face her mother.

It is two in the morning. There are no social workers to help ease the news I must deliver. I lead her, tears in her eyes, to a quiet place where we can talk. My heart sinks as I remember the words from my daughter’s book, “Oh the Places You’ll Go”. I have been in this place before, “The Waiting Place”. It might have been one of the last books I read her.

Her mother looks at me expectantly, almost pleadingly. Her emotions are plain to read, if you know the language. I do, as only one who has gone through this can truly understand. There is fear and grief. Worry mixed with hope. I introduce myself as the doctor on for the Pediatric ICU, though in truth I know she will not remember me. “I am so sorry to have to tell you this. It seems your daughter was born with a severe heart condition”. It is the moment she will remember, the one where her world stops turning. I say some words to fill the silence, or maybe silence the screaming in my own mind. “We are working hard to stabilize your little girl… the cardiologist will be here soon… She will need to be transferred to a cardiac facility… I know how impossible this must all seem.” This last one catches her ear. She looks up from wringing her hands, the helplessness she is feeling manifesting as anger. “Do you?” she asks. I hesitate.

Tonight is not about me, my grief, my loss. Tonight, this moment, is about her, and her daughter, and the battle they face. I begin to apologize, to take back my words. Then, the memories flood over me. She has a lonely road ahead of her. I take out my phone and show her the photograph on my lock-screen. An infant girl with dimpled cheeks and a hint of a smile at the corner of her lips, the NG tube and heart shaped sticker holding it in place betraying the truth of her illness. There is silence, I don’t know for how long.

“What if she dies?” she asks with tears streaking her cheeks. She does not want the question answered, she wants to know that she is not alone. I reach for her, and she crumples in my arms. I do not remember what was said next or how long we stayed like that, holding each other. In that moment, I was no longer her doctor, and she was no longer my patient. We were mothers.