by Robert Lanz, LCSW
On my last night of work—my last shift ever—there was a small party for me in the nurses lounge. The usual fare was served: chocolate everything with copious amounts of coffee. These going away parties never got too emotional and were usually unfocused and brief as there was always, always, always, a cardiac arrest or other trauma to disrupt things. Any tender emotions that staff members might have been feeling regarding my leaving would have quickly shifted to anger or disgust following an overhead page about some incoming disaster. Sad goodbyes, even after thirty years, took second place to code traumas or code blues, which was always a real possibility and everybody knew it.
With that in mind, no one ever got so caught up emotionally that it would have been hard to shift to an entirely different mental state, thereby bringing an abrupt end to the party. Besides, everybody knew that I would be throwing a huge all-out bash at a local pub within the month, at which no one, except for the cops and paramedics, would have to leave from abruptly. I would then have the appropriate and lengthy sendoff that I had earned.
I’m not sure what I expected for my last night. Not that my expectations mattered. As they say, “it is what it is”. The rest of the world wasn’t going to be different just because I was ending my career in the hospital where I had spent half my life since kindergarten. To the rest of the world it would be just another night. Maybe something wild would happen. Maybe not. Maybe I’d be bored or maybe someone will throw up on me- more than likely, I wouldn’t be called upon to give any good news.
To be honest I was probably a little more affected by it all than I let on and probably everyone knew it. I walked the halls and looked around, seeing things that brought so many memories, good and bad. All those strangers’ deaths and all those friends’ deaths. It was really hard not to wonder when it would be my turn.
About one in the morning the shifts had changed and the overnight nurses were settling in with the overnight docs. I wanted to hold them all and squeeze them all of course, but that would have been a little overboard, so I just bid them goodbye and told them I’d see them at the Adios Party. I thought I’d finished when I heard the phone ring.
“Hey Bob, can you come down to room fourteen? Got a kid with a weird head injury. No one speaks English.”
A kid with a weird head injury could mean anything. The overnight social worker was already with another patient but she didn’t speak Spanish so I figured I’d go ahead and get things started. If it turned into a Children’s Services and police nightmare like it could have, I’d get things started and find someone to translate and let the overnighter finish it herself.
The doc headed me off in the hall and took me to the X-ray box- never a good sign. He started giving me the history while he searched for the digital image of the kid’s skull.
“The kid says he fell and hit the wall at school and wouldn’t stop crying so the school called his father to come and get him.”
After so many years, you learn that nothing is that simple. But this case didn’t present a very suspicious mechanism of injury, so why was I there?
“And with that history you sent the kid over for a CT scan? What’s up with that?”
“He wouldn’t stop crying. He seemed a little dizzy. I thought he might have had a concussion but with that lightweight fall it wasn’t likely. Oh. Here’s his scan.”
The box lit up his skull in almost three-dimensional clarity and I was reminded of something I always joked about. You know how to tell a bad break on a CT scan or X-ray? Even the social worker can see it.
And there it was, a tumor the size of a walnut. The tumor that would have caused symptoms sooner or later and the little head whack at school just made it sooner.
“Big tumor. What do you want me to do?”
“I don’t speak Spanish and this will probably be emotional so I need you to be there.”
“And what about that tumor?”
“Probably kill him in a month or so.”
“And I have to tell him that?”
“No. It’s your last night. We’ll send him down to Children’s Hospital with a copy of the scan. Let the neuro guy down there tell them.”
I didn’t tell him but the neuro guy down at Children’s wasn’t a guy, she was a woman. She lived across the street from me and was a long-time friend. I’ve seen her many times since then, but I never asked her about that little boy. I don’t do that kind of work anymore.