Kayla E. Cushner CWA 2012

Emma

I think you knew what was going on more than you let on. You were looking at one of those teenybopper magazines covered with pictures from High School Musical, gaggles of American teenagers with toothy smiles and perfect hair. I was sitting in chair that was too small for me at a round table that was too low to the ground. The hospital playroom was overly full of brightly-colored toys, a cheery display that felt like a fake smile when you’re trying not to cry.

Your parents were in the corner, talking to the doctor in the white coat. His eyes were filled with bad news and theirs sunken with a kind of unspeakable exhaustion, once again defeated by the cancerous cells invading your blood and taking over every inch of your tiny body. The cold February light intruding through the two large windows revealed a washed-out hue on their skin that comes only with spending weeks on end in a 10x10 hospital room.

I wasn’t sure what to say to you. You were a 7-year-old dying of cancer and I was 23, with so much life in front of me: a map of decades that my mind had filled with adventures and mistakes, with love found and love lost, with babies and a family, with profound sadness and unfathomable bliss, and all the trips to the grocery store in between. And you hadn’t even had your first kiss or stood awkwardly with a group of 12-year-old girls at a middle school dance or gone to your first concert. You hadn’t found your best friend or your first crush or your favorite book or that song that you can listen to over and over again without getting sick of it. I had lived for 23 years and you had lived 7; the whole thing just didn’t seem fair.

It was the prom issue of the teenybopper magazine and I saw you looking at the pretty girls in their frilly pink and purple gowns. “Which one would be yours?” I asked. You finally looked at me, surprised, like I had asked the perfect question. Your voice was soft and high-pitched, eager and quick, “Um, um, well, see, I’d wear this one. Or, actually, this one, this is the one I’d wear.” “And which one of these boys would be your date?” You giggled quietly at the silliness of the question, like any 7-year-old girl would.

For a moment that passed all too quickly, I forgot about the big metal IV pole, 3 times your height, which held you captive with its clear plastic tentacles. I forgot about your frail body that had become too tiny for your head, which was now covered with thinning, wispy hair. I forgot about the diapers you had to wear and your urine that was red with blood.

“Which one would you wear?” You asked timidly. “I like that one too,” I pointed to the same gaudy purple dress that you had claimed as your own, “but I guess I can’t wear that one because that’s yours, so…I’d wear this one.” Your smile was weak, but it was real, the most honest expression I had seen all day.

The IV pump started beeping. “I need to go to my room,” you told me, “do you want to come with me?” We walked slowly down the florescent hallway to your hospital room, which you had covered with glittery signs that displayed your name in bubble letters next to colored-in pictures of puppies and princesses. Your parents sat down in their perch on the plastic grey couch a few feet away, watching us intently like we were having our first playdate. You showed me your latest project, a collection of colorful beads strung together into long, mismatched necklaces, which were draped against the faded blue of your hospital gown; your gown was neither frilly nor purple.

The doctor came in and said he wanted to “take a look” and you lay down on your bed and your mom lifted up the dingy blue gown and took off the diaper. “Where does it itch?” He asked. You pointed. It was the first time I had seen you whimper, uncomfortable and exhausted. He diagnosed you with yet another infection, your tiny body, born in 2004, breaking down at an unbeatable pace.

The next day I came back and brought with me a red and yellow woven bracelet I had found tucked in a drawer in my apartment, something I had made years before, during the summer I spent as a camp counselor, and had never tied onto my wrist. I walked into your room and your face, though tired, revealed your excitement at the return of your new friend. “I brought you something,” I said, and took the string bracelet out of my pocket. “Do you want me to put it on for you?” “Yes, I do,” you said. I sat down on the edge of your bed, looped it around your tiny, fragile wrist and tied a tight knot. I made it as small as I could, and still it slid up to your elbow. Cutting off the extra string on the ends it occurred to me that this insignificant string bracelet I had made at summer camp was probably going to remain on your arm for the rest of your life, that a morgue attendant on an overnight shift in a cold room in the basement of the hospital would probably be the one to cut it off of your cool, grey skin. “Thank you,” you said softly, interrupting the snowball of morbid thoughts with your sweet, timid voice. I tried to smile back at you as the heaviness in my chest simultaneously dropped into my stomach and flooded my throat.

A picture next to your bed caught my eye. “Is that your sister?” “Yes,” you told me, “that’s Katrina. She’s 2.” Your dad handed you a small photo album, “Why don’t you show her the pictures?” he said. You opened the cover slowly, each small movement sucking up your lasts drops of energy, and there was a picture of a happy family – a mom and a dad and two healthy little girls in front of a Christmas tree. You were unrecognizable and your parents only faintly resembled the couple in the photograph. Sallow skin, sunken eyes, you were shrinking away. To me, the contrast was jarring. But for you, it was your real life, it was your family before all the doctors and the medicine and the sickness broke it apart. Later, the nurse told me that your baby sister had been sent to be with family in Boston because it was against policy for her to sleep over in your hospital room, where your parents now lived alongside you. All day. Every day.

As I was leaving you said, “I like playing with you.” And I told you I liked playing with you too.

And that was it. When I came back the next week you were gone. The nurse said it happened quickly, two nights before. Your body was too broken and, in the middle of the night when the doctors could no longer hold onto your life, you left.

And in that moment when you left your small, weakened body, all the love that your daddy felt for you was so big that it exploded, and it broke him apart. The quiet, reserved man I had met just one week before had shattered so completely that he was taken directly from the pediatric oncology floor to be admitted to the psychiatric unit across the street. “He had a complete mental breakdown and nothing would calm him down,” the nurse had told me. You did not shatter him though. I want you to know that. You had no choice really; youth promises all children invincibility and she betrayed you. But you were the life he had created and for as hard as he tried and as much as he refused to give up, he could not hold onto you.

I came to nursing school because I wanted to be a midwife, because I wanted to guide new life into the world, I wanted to be there when parents meet their child for the first time. Last week I caught my first baby. A few minutes before she was born, the whole room began to spin in a sort of methodic chaos, preparing for her arrival. She started to come out and I pressed my fingers on her head and before I could even process what was happening, she slid out into my hands and she was born. With all the commotion spinning around us, it was surprisingly quiet at the center of it all. The reality was simpler than I had imagined: one minute she was hidden from the whole world, and the next she was there, breathing and crying, alive. I placed the slippery baby on her mama’s belly she met her daughter, watching her with utter disbelief. The nurse leaned over the newborn to fasten an identity band around her tiny ankle and I thought of you, watching diligently as I tied the red and yellow bracelet tightly around your delicate wrist.

I met you in the last week of your life, in the middle of the final chaotic scramble as the doctors gave their last ditch efforts and your parents held on tightly, hoping for the impossible. And you were at the core of it all, a 7-year-old girl gracefully retreating back from your brief existence. One year ago, I had the honor of spending a few hours with you in your calm, brave stillness at the center of the whirling chaos of grownups trying to grasp tightly as you dissolved within their palms.

Kayla E. Cushner

Kayla E. Cushner graduated Cum Laude from Kenyon College with a Bachelor of Arts in English in 2010. She is a cellist, childbirth educator, and doula. While at Kenyon, she conducted an independent study on “Birth in America.” Kayla is currently an RN working on the Maternal Special Care Unit at Yale-New Haven Hospital. She is in her second year at YSN and will graduate in 2013 as a Certified Nurse Midwife.