Contact Information:
Sarah M. Reel, MD
Categorical Pediatrics Resident
Cincinnati Children’s Hospital Medical Center
3333 Burnet Ave, Cincinnati, OH 45229
He was five years old. He had a short buzz cut, mischievous eyes, and a
smile that stretched from ear to ear. His laugh filled the room, and his
favorite superhero was Iron Man. I first met him when I rotated on the
Pediatric Surgery service as a third-year medical student. Mom had to be
away from his bedside to care for her other children, and as the medical
student, I had more opportunities than other providers on our team to
spend time with him. We had superhero battles, played hide-and-seek (the
best spot was behind the curtain), and watched movies.
He was listed for resection on a day that I was at the hospital. We
looked through his scans prior to the case and talked through the
methods they would use to dissect the tumor from any remaining healthy
tissue. I read about his oncologic diagnosis and about the treatment
course he was facing. I still remember standing in the operating room
and watching the surgeon remove a large tumor. She presented it to me
with both hands before it was taken to be labeled and sent to pathology.
The next few days while I was on service, we would go into his room in
the early hours of the morning to ask if he pooped, if he had pain, or
if he liked the cafeteria chicken nuggets. He was always ready to play
despite the pain and the early hours, and the other medical student and
I would memorize a new joke to tell him each day.
“What is Iron Man’s favorite drink? Fruit punch!” He always laughed.
By the time I rotated back to Pediatrics later that year, I knew that I
was going to be a pediatrician. I was excited to be assigned to a week
of Hematology and Oncology. During that rotation, the little “Iron
Man” was re-admitted. This time it was for fever with neutropenia, a
common concern for patients undergoing chemotherapy. When I went into
his room to see him, he was crying. His mom was holding him, rocking him
back and forth. She was telling him a story about rain and the hardships
we all face in life.
“The rain comes, and it might look grey and dark outside, but it is
helping the flowers to grow,” she said. “When the sun comes back, the
rain will dry, and the flowers will be left shining in the sun.” She
went on to explain to him how coming into the hospital was a cloudy part
of his story currently, but that the sun was coming. It was true – he
was soon up and running around with his brother. His counts recovered
and his cultures were negative. I went to see him the morning that he
was going home.
“What did Iron Man say to Spider Man? Don’t bug me!” He smiled and
waved to me before they left.
Our paths crossed again during my fourth year of medical school, when I
selected to rotate on the Pediatric Hematology and Oncology service as
an Acting Intern. This time, something was wrong. His face was puffy,
and his body was weak. We ordered imaging and labs. His disease had
greatly progressed. The attending came to review the scans with the team
in the workroom.
“This is it,” he said with finality. He discussed the findings with
the family, and we watched mom’s heart break in front of us.
The pediatric unit has a bell hanging in the hallway. It is brought to
life by patients who ring it to proclaim that they have completed
treatment for cancer. Our care team talked with the patient’s family,
and mom expressed to us that it would mean a lot to him to ring the
bell. We all agreed. On that day, many of his former providers lined the
hall. We held confetti to throw as he rang the bell. Despite being
swollen and bruised, his smile was huge as he rang the bell over and
over. He was thrilled, and we all cried. Afterwards, I picked up a piece
of blue confetti and tucked it in my pocket (Fig. 1).
I am a resident now, living the days that I dreamed of as a medical
student. This summer, I will apply for a fellowship position in
Pediatric Hematology and Oncology. Whenever I contemplate my career, I
remember this superhero who lived fearlessly and fully to the end. It is
no surprise that he gravitated towards Iron Man, someone who was brave
and determined in the face of danger. To this day, I carry the piece of
confetti in my wallet as a reminder that even on the hardest days, the
sun is coming.