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College of Arts and Sciences

Escapade Into Blue

By Bound · On January 28, 2014

Savannah Krebsbach - College of Arts & Sciences

The woman sat and watched her daughter lying on the hospital bed, tubes protruding from her small body and an IV stuck into her arm. Crying softly, careful not to wake her up, the woman gently put her hand over her daughter’s. The light on the tip of the little blonde girl’s finger glowed softly in the dark room. The air cannula around her face was not doing its job—the tiny fingernails continued their escapade into icy blue. The woman laid her head on the edge of the bed, tears changing direction as they coursed now towards her temple.

This is how I imagine my mother may have reacted the first night my sister, Taylor, spent in the hospital. Strong, holding it together for everyone during the day, and then it hit her. Her baby girl was in the hospital. Hooked up to strong IV antibiotics and feverish, she thought back to the x-ray results from earlier in the day. How could her three-year-old’s lung be filling up with fluid? How could this be happening to her?

I do not remember very much about my big sister’s hospitalization. In fact, I would venture to say I do not remember anything at all. As long as I can remember, she has had scars on her right side. For a long time, we did not talk about them. All I knew was that I was not allowed to touch them. Nobody was.

When I was about eight or nine, I remember one day when my mom was going through and organizing old pictures and photo albums. She came across one in particular that caught my eye—I had never seen it before, and it was covered in dust, as though it had never been opened after it was filled. I asked to look at it, and my mother hesitated. Handing it to me, I took it and opened it slowly.

Inside were pictures that I did not quite understand. Two in particular caught my eye: my sister looking too small in a hospital bed, her hair a mess, and me sitting on the end, smiling up at her, and my sister standing in the hallway, tubes protruding from her body, connected to an IV, and gripping the IV stand, wearing her red Elmo slippers.

I remember talking with my grandparents when they would come to visit us from Nebraska. Sitting on my grandma’s lap, we would laugh as my grandpa told a story about me when I was almost two. “We were in the hospital parking lot,” he would say to me. “You were wearing those damned little high heels of yours, and taking those itty bitty steps.” Here he would pause, shake his head, and look at me with ornery disbelief in his eyes. “I said, ‘C’mon Savannah!’ and you just kept taking those itty bitty steps. Well, I just got fed up with it and picked you up, carried you like a football into the elevator…and my were you screaming!” At this point, he would chuckle, and push his glasses up. “And, I’ll never forget, there was this little old Indian guy, sitting by the entrance to the hospital, just laughing!” And here, at this point in the story, my grandpa and grandma would both burst out laughing, as I mingled my laughter with theirs. It is hard to describe the joy that this story can bring to my grandparents, and every time I think of it, I cannot help but smile. It was not until I saw the pictures in the photo album that I realized this story that brings us so much laughter is set in such a trying time. Now that I am older, I decided to learn more about this time in my family’s history, and how something that is never talked about can have louder implications than one might think.

On Saturday, January 28, 1995, my family took a road trip to Santa Rosa, New Mexico, to meet my Uncle Steve, a trucker passing through, for dinner. I’m told that while at the restaurant, or sometime on the way home, my sister had developed a rash that would not go away. My parents called our pediatrician, and he recommended Benadryl. That Sunday was Super Bowl Sunday. The San Francisco 49ers were taking on the San Diego Chargers. My mom went to work at Walmart. My dad noticed that Tay was not feeling well, so he suggested that we both spend the day in our pajamas, relaxing.

The next day, Monday, Taylor’s temperature was still very high, so my mom took her to visit Dr. Saland, our pediatrician. In the waiting room, my sister and I played with the toy train set—the best toy in the office. She checked out fine, with symptoms of a cold or the flu.

Dr. Joel Saland was trained in New York City at Montefiore Hospital and Columbia Presbyterian Hospital as a pediatrician. He has been the Chief of Pediatrics at Presbyterian Hospital twice. He worked for Public Health Services for many years, serving Navajo and Hopi indigenous populations in New Mexico, and after a time, he opened his own small practice in Albuquerque, New Mexico, with one registered nurse and one office manager. I shadowed with Dr. Saland when I was a junior in high school, and first becoming interested in medicine. I was always amazed at how smoothly his office ran with only three people to steer it through the sea of anxious parents, sick children and snotty siblings. Dr. Saland’s quiet demeanor and calm composure in the face of any case that came in was admirable in my eyes. He could handle any situation that came in by listening to the problem, asking prevalent questions, doing a thorough examination and then drawing on years of experience to come up with an exact diagnosis. He inspired me to become a doctor, and he continues to inspire me today when I think back to my time shadowing him.

When Dr. Saland received a call from my mom on Wednesday saying that Tay had a fever of 104 and appeared bluish, he said to bring her right in. My dad balked at the idea of taking her back to the doctor when my mom called him, at first. She was just there on Monday, why take her back? When he heard of her bluishness, however, he decided to meet them at the pediatrician’s office.
Imagine, the middle of winter, peak flu season and kids are in school, exchanging germs and bugs like crazy. Now imagine, the packed waiting room of a tiny pediatric office of a doctor who has twice been chief of a hospital pediatric unit. Imagine the phone ringing off the hook of concerned parents wanting advice, wanting appointments, wanting to talk with the doctor himself.

Imagine the cold, almost spring, wind outside, which sweeps in the door every time it is opened. Now imagine, a man and woman sweeping in with the next gust of wind, a small blonde girl hanging limp in the man’s arms, a bluish hue infiltrating her fingers as they sit limply against his chest. What would you do, with your sick, sniffling children playing around your feet? Would you let these other desperate parents go first?

Visibly concerned, the patients in Dr. Saland’s office that day did let my sister go first. Dr. Saland saw her right away. He took one look at her pallor, listened to her chest for about 20 seconds and told my parents that she had pneumonia. He told the nurse urgently to take her straight to St. Joseph’s Hospital Downtown, directly to the pediatric floor, not to the emergency room. He would call ahead and have everything prepared for her. Once there, he visited her every day.

Once at the hospital, the doctors took a chest X-ray. The scan showed that her lung was filling with fluid and that she needed to be started on antibiotics right away. My small, three-year-old sister was placed on an IV and antibiotics. And as she lay in her hospital bed, feverish and blue, my parents stood by and worried.

On Feb. 1, 1995, Taylor was doing better, the doctors said. She would be able to go home today. My mother was at home with me, and my dad was at the hospital with my sister, preparing things to go home, and waiting for the last set of X-rays to be done. Thirty minutes after Tay was taken for X-rays, the radiologist came out and asked my dad for permission to do an ultrasound to check something and “be sure”. Of course my father agreed. About an hour later, the radiologist came back out and informed my father that my sister would not be going home today. In fact, she was so much worse that they could not give her the treatment that she needed at that hospital, and she was going to be transported to the University of New Mexico Children’s Hospital. Shocked, my father rode with Taylor in the ambulance to UNM, where she was directly admitted into the Pediatric Urgent Care.

Your baby is in the hospital. She is coming home today. You are at home, ready to get back to normal, telling your youngest daughter that Tay will need some more time to rest when she gets home, so she won’t be able to play for a while still. You’re waiting. Why aren’t they home yet? They should’ve been back at least half an hour ago. Looking out the window every time you go past. Then you get a call from your husband. Your heart stops. You can’t believe what is happening; the joy has been sucked out of your world and into the phone from whence the news came. Your baby is worse.

My mother called my grandma. My grandma called the airport. She left her farmhouse in northeastern Nebraska, got in her blue pickup truck without anything but her purse, and drove. In Lincoln, she got on a plane, and in Albuquerque that same day, she got in the car with my mom.

Meanwhile, my mom was panicky. She left me with the neighbors and wanted to go to the hospital right away. But my dad told her to wait. He knew that it could be too much for my mom, and besides, someone needed to pick Grandma up from the airport. So she waited, the weight of the unknown beating down on her heart.

Meanwhile, my dad was making decisions. Tay had been admitted to the sub acute ward, and the doctors were arguing over whose case she was—respiratory or surgical. Respiratory won, and as my dad held her tiny hand, the doctors inserted a chest tube, using Versed to put her semi under, and as the antibiotics still pulsed through her body. He did not tell my mom until she arrived at the hospital with my grandma.

Do you remember when you turned two? If you have kids, how did you celebrate their second birthdays? You probably had a party with friends and family, with cake that got smeared all over the children’s faces and maybe even balloons. Mine, February 4, 1995, was not spent with my family. There was no cake to be smeared all over my face, and I do not think I had balloons. The neighbors took me to McDonald’s to make it a special day for me, as my family waited at the bedside of my sister.

As I enjoyed my french fries with the neighbors, my sister was not eating. The pneumonia was affecting her appetite, meaning she could not hold down food and was not getting the nutrients her body needed. The doctors inserted a feeding tube. The antibiotics mixed with the new input of food caused my sister to have severe diarrhea. Unable to control her body, three-year-old Taylor asked to be able to wear diapers. My mother was devastated—she didn’t know what to do. My father was frustrated. He’s a fixer; it’s what he does. With no medical training or background, however, he was left in the dark, unable to help his daughter at all.

The doctors, however, could help my sister. She had a team of surgeons and pulmonologists led by the hospital’s head pulmonologist on her side, fighting for her. They were constantly having meetings and brainstorming new ideas of treatment for Tay.

On Feb. 7, they decided to pull out her chest tube and take a new set of X-rays. After waiting about two hours to make sure the wound was sealed, they took more X-rays, which showed that there was air infiltration. Attempting to calm my parents, the doctors told them that it could be from when they took out the chest tube. They waited another couple of hours and took more X-rays. There was more air infiltration.

Realizing that Taylor’s lung was collapsing, the doctors inserted another chest tube in a new incision and decided that it was now the surgeons’ turn to act. Surgery was scheduled for Feb. 9. Grandma called Grandpa and, as a trucker out on the road, he got a load to Albuquerque as quickly as he could and arrived on the day of Tay’s surgery.

Now imagine that you are a parent and your three-year-old daughter is about to go in to surgery where doctors will access her lung through her rib cage and assess the quality of the tissue. They will either work to fix the hole in it or to remove it. Imagine watching her rolled towards the operating suite with a hair net on her small head, and her baby doll, which she randomly named Camp, next to her on the bed, a hair net on her head, as well. She is scared and looks too thin from the weight she has lost. She cannot breathe very well, and you feel so helpless. It is not only her life that the surgeons hold in their hands, but your life, as well.
Now imagine that the surgery was supposed to take an hour and a half to two hours. It is four hours later, and there is no word on her condition. You are worried, and you see the surgeon come out. He says the surgery went well. She was narcotic resistant so it was difficult to get her out. You are flooded with relief. Then you see her wheeled out of the elevator going to the Intensive Care Unit, naked, unconscious, being manually respirated and tubes protruding from her small body. You are surprised—it doesn’t seem like you were meant to see this—and you are reminded that the fight is not yet over.

The upper lobe of Tay’s right lung was necrotic. The surgeons removed a portion of a rib and removed this dead portion of her lung. They inserted more chest tubes during surgery, as well, and now had twice as many as before. When my grandpa got to the hospital, he was falling apart emotionally. The doctors took Tay out of sedation briefly to show my family that she was alright, and then put her back under for another day. They told my family to go home and get some rest because she would be under anyways.
Taylor spent two days in the ICU. The boy she shared a room with had respiratory syncytial virus. He died the first night. Still worried, my family watched as Tay recovered. She had 21 different things coming in and out of her body and there were tubes everywhere.

Sitting by her bedside, my dad watched as the chief pediatric surgical resident checked Tay out. Watching the kid-like manners and sensitivity that he emanated, my dad could not help but feel the love and concern of the workers around him. He thought about her stoic attitude and how strong his baby girl had been. As the chief pediatric surgical resident turned a tube that chest tubes come in into a light saber for my sister, he could not help but feel the special impression that she had made on all the people who had come into contact with her since her arrival.

When it was my mother’s turn to sit with my sister, she noticed the beautiful nurse. “Beautiful because she was the kindest nurse and took excellent care of Tay.” She gave my sister a bath and fixed her hair pretty, making her a very special princess.
As my grandmother sat with my sister, she sewed. She worked on a small wallhanging that portrayed a young native girl. My sister watched quietly.

My sister watched E.T. as she was recovering. Pointing to her index finger to which her pulse-ox monitor was clipped, she decided that she, too, had a glowing “E.T. finger”. Then as grandpa sat with her, he ate all of her Reese’s peanut butter cups.
On Feb. 11, Tay was transferred to the other side of the hospital to a normal room. Even though I was not supposed to, the nurses let me visit my sister in this new room. I needed to see that she was okay and we were both so happy to see each other. Everyone was extremely happy.

On Feb. 16, the last chest tubes were removed. Taylor was walking in the hallway, grasping onto her IV stand, posing for pictures in her Elmo slippers, when the nurse came by to get her for the procedure. All of the other times before, Taylor had not reacted when chest tubes were inserted or removed. This time she screamed, and it was joyous. Joyous because she cared, and she was better, although still weak. The last X-rays showed that everything had healed. On Feb. 18, Taylor left the hospital in the homecoming dress that Grandma had made, and I greeted her in my matching one at home.

Life went back to normal then. It was an emotional release and a relief to return to routine, daily things, and my mom made sure to keep the house extra clean. My sister began gymnastics to regain strength in her body and I remember being jealous that she got to do this fun sport, but I did not. I did not understand why and I remember asking my mom as I watched her tumble across the floor. I do not remember her response.

Later that year, my parents saw a 20/20 episode on television about three kids in New Mexico who had been infected with the same type of pneumonia as my sister had been that same winter. It was the same type of quick onset, but all three cases, unlike Taylor’s, had resulted in death—two en route to the hospital and one shortly thereafter. My parents never met the families of these other children.

Now, when my parents think back on this experience, it is different, tougher. They claim that it did not change them very much, but I tend to think differently. People are affected by things in small ways that they cannot see. Through my investigation and writing, I believe that they were affected. It is difficult to pinpoint what it is, but it is there; a change like that in a person revived from the dead with an electric shock. It’s a change that only expresses itself in the deepest fiber of their beings, but can surface unexpectedly—when their three-year-old baby graduates from high school, when their daughters decide to take a road trip by themselves, and when I got walking pneumonia last winter. It is so subtle that the untrained eye would not notice. A glitch. A stitch. A scar.

My sister normally forgets about her scars. They have grown over the years as her body has grown, and she doesn’t usually get asked about them. She has, over the years, become used to them. She has developed habits that avoid contact with them, as they bother her only when touched. A rub, a poke, a graze will result in a flinch. However, it is only touch that will help her to desensitize. So she tries. She does not remember very much from her experience, but she was affected, as well.
Now it is 2010. You are sitting in Dr. Saland’s waiting room when his nurse calls your child’s name. You walk back with your baby and sit with her in the exam room, looking at the alphabet quilt hanging on the wall. Dr. Saland walks in and greets you. “Here for a vaccination. No concerns? Okay, I’ll have my nurse get that ready.” You say thanks and wait a little more and Dr. Saland shakes your baby’s little hand and walks out, wishing you a good day. The nurse walks back in and injects the thigh of your infant, who looks confused and then starts to cry. The band aid is in place, and you’re ready to go. Before leaving the room, you take one last look at the quilt on the wall, and you silently thank all that is good that pneumonia is now off your list of parental concerns.

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