Saving Elijah

disappeared.

    *    *    *

    The next morning after Moore came for his rounds, I wandered out of Elijah's room while Sam's sister Anne was visiting. Dr. Jonas was sitting at the desk, working on one of the computers. He looked up as I approached. I asked him if I could have saved Elijah the night he had the seizure by sitting up with him and watching him all night.
    "He was sick," I said. "I should have been with him."
    The young doctor sighed. "All the signs are positive. Try not to blame yourself, Mrs. Galligan."
    Right.
    The doctor put his hand on my shoulder, then went to attend the Spanish child in the silver blanket, whose monitor alarm was beeping, whose mother was screaming something that sounded like "Socorro!" Help! sounds the same in any mother's language. As for me, I was standing at the desk in the center of the PICU, and I was sucked into a horrendous vision of what I was now convinced was my future. I was cornered and chained and caged.

    *    *    *

    Morning. A conference room, a large oval table. A white coat convention, formal this time, hands folded neatly. Dr. Moore, his third partner, Dr. Lambert, the head of nursing on the pediatric floor, the pediatric social worker, the chief resident, the chief surgical resident, Sam, and me. Table for eight. No Dr. Angus.
    "Gastrostomy and fundoplication," Moore says, dart-dart. "It's a simple procedure. We insert a tube into the stomach for the feed. And the stomach will have to be moved, and we have to put a special flap in the esophagus. Takes about three hours."
    Sam draws a deep breath. "Why do you want to do this?"
    Moore glances down at the papers in front of him, as if to check for the reason. "Because he's been vomiting his feed."
    We already know this, of course. Every time a nurse fills the tube in Elijah's nose with the white liquid they call "feed," it comes back up again, out of his mouth.
    "If you just insert the feeding tube into his stomach, will that stop the vomiting?" Sam asks.
    "Probably not."
    "But what's the point of doing it, for God's sake? Dr. Angus described Elijah as hopeless. And now you're proposing to do a complicated three-hour operation to rearrange his organs? If Elijah can't keep that stuff down, maybe his body is telling us something."
    "It's not complicated at all. The surgical staff does that operation all the time."
    "Are you saying now it's not hopeless?"
    I close my eyes to block it all out, but shutting my eyes does no good, none at all. I still see the bright lines galloping across the monitors, I still hear the whoosh and pump of the respirator. And I can hear a phone ringing somewhere, the beep of a patient call button, the rattle of a cart, the nurses chatting at their station, their laughter. I noticed a cake when I walked in the corridor before. People do have birthdays.
    "No," Moore says.
    "No, it's not hopeless?"
    I open my eyes in time to see Moore hide his hands under the table. "There are chronic care hospitals." He looks at Dr. Lambert. "What about Laurel?"
    "This morning I spoke to admissions there," the social worker says. "They won't take him with a nasal tube. The tube has to be put into his stomach. That's their rule."
    "But you said the other day they would." My voice is hoarse, a croak, as if I have been talking for days. "That's why we made the appointment."
    Dr. Moore has a hint of a smile. "So he'll have to have the operation after all."
    Sam has his head in his hands. "What about hospice?" He looks at the social worker, who suggested this only yesterday.
    "Hospice won't take patients with respirators," the social worker says. "It goes against their philosophy."
    And this, too, we know. All extraordinary means of keeping a patient alive must be removed for them to be admitted to a hospice facility.
    "And the order to remove has to come from this hospital," Moore says. "Look, these things are very complicated ethical decisions that people have argued about for many years. These are decisions not to be taken lightly."
    "Lightly.''" I can see the pulse throbbing at Sam's temple. "How dare you! You don't know anything about us—"
    I place my hand on top of Sam's. Don't get him mad at us, Sammy. We're at his mercy. But oh, I want to tell this arrogant man how much we love our son, how hard we've tried for him, how—
    "Just because a child is handicapped doesn't mean you kill him," Moore says.
    Kill him?
    The social worker and the head nurse exchange glances. Is he saying removal of