Laura Johnsrude is a retired pediatrician living in Louisville, Kentucky. Her essays have been published or are forthcoming in Fourth Genre, Bellevue Literary Review, River Teeth, Hippocampus, The Spectacle, Please See Me, Minerva Rising, Drunk Monkeys, Under the Gum Tree, The Examined Life Journal, Sweet: A Literary Confection, The Boom Project anthology, and on Brevity’s Nonfiction Blog. Take a moment to read her Field Notes essay “Beholding Something Fine” (Fall 2023 Intima),
When I read “All Tuned Up” by Albert Howard Carter III (Spring 2021 Intima), I remembered a pediatric intensive care unit patient from my own 1980’s residency experience. In Carter’s poem, a medical resident presents a case during mortality and morbidity rounds. The resident is moved to tears as he tells the gathered audience about the death of a patient he knew well. A senior doctor “gently” offers context and says, “Maybe he was just tired.”
Mercifully, I’ve muffled memories from some of the deaths during my residency training in the pediatric intensive care unit. But I remember a slight girl of about sixteen with silky, wavy hair, lying in a metal-frame bed parallel to the wall against the window, in silhouette.
She was one of those patients known to everyone, as she’d been born with a condition that caused liver failure and had been admitted to our hospital many times. My memory is that she had alpha-1 antitrypsin deficiency. She’d had a liver transplant and I think she’d had more than one. This was decades ago, so I’m not sure.
Her liver had failed again, at the end. My recollection is the culprit was cytomegalovirus.
She was tired, she said. She made the decision to stop getting procedures.
She made the decision to die from anemia, by just drifting off to sleep.
No more interventions. No more transfusions.
I was on her PICU ward when he came in, the pediatric gastroenterologist who’d known her all her life. He was there to tell her good-bye. Walked directly to her bedside and leaned in to speak quietly to her.
I remember feeling his grief and affection for her, his patient. It filled the room.
We all turned away as he leaned down close to her, this tired young girl.
In my Intima Field Notes essay “Beholding Something Fine” (Fall 2023 Intima), I wanted to manage the newborn, to remove any meconium from the baby’s mouth—quickly—before the first breath. And then I wanted the baby to breathe, to cry. I wanted the baby to live.
But sometimes caregivers cannot direct the outcome. Sometimes caregivers come to the bedside and sit down, reach for a hand, lean close to speak quietly.
The mercy of it—that moment between a tired, brave girl and her kind doctor—has stayed with me, all these years later.—Laura Johnsrude
Laura Johnsrude is a retired pediatrician living in Louisville, Kentucky. Her essays have been published or are forthcoming in Fourth Genre, Bellevue Literary Review, River Teeth, Hippocampus, The Spectacle, Please See Me, Minerva Rising, Drunk Monkeys, Under the Gum Tree, The Examined Life Journal, Sweet: A Literary Confection, The Boom Project anthology, and on Brevity’s Nonfiction Blog. Johnsrude’s piece, “Drawing Blood,” won Honorable Mention for Bellevue Literary Review’s spring 2018 Fel Felice Buckvar Prize for Nonfiction. Her book reviews have been published in Good River Review.