Immy was a frail little girl, the only child of older parents. At 3, she was only as big as the average 18-month-old toddler. She was unable to walk more than a few blocks without tiring and did not have the strength to play games you could not play sitting down. A desperately wanted and long-awaited baby, she had been born with a hole in her heart and a badly formed heart valve. Only the most careful medical management had helped her to live until she was big enough to undergo extensive open-heart surgery. She had been followed since birth in our Pediatric Cardiology Clinic at New York Hospital, and many of the pediatricians knew her and her family. Despite her physical difficulties, she took full possession of all the hearts around her, including mine.
When the time for her surgery finally came, her parents were deeply anxious. These were the early days for many cardiac surgery techniques, and the risks were considerable, but without surgery she would not survive childhood. As the senior pediatric resident, I met with Immy's parents before the surgery to do an intake interview and summarize Immy's long story. They were committed and ready and very pale. As we spoke, they sat close together holding hands. Afterward, I took them with me to the children's ward to examine Immy. She greeted us with her take-no-prisoners smile. She was holding a new teddy bear. Someone had put a white bandage across its chest.
I examined Immy carefully. Her heart sounds bore no resemblance whatever to the organized sounds of a normal heart. Once again, I marveled at her endurance. As I helped her to dress, I noticed a St. Christopher medal pinned to her tiny pink undershirt. "What is this?" I asked her parents. Hesitantly, her mother told me that a family member had made a special trip to Rome to have the medal blessed and then dipped into the healing water at Lourdes. "We feel that it will protect her," she said simply. Her husband nodded. I was touched.
Immy spent the next day or two undergoing tests, and I saw her several more times. The medal had been moved from her shirt to her hospital gown. It had seemed so important to her parents that I mentioned it in passing to the cardiac surgery resident as we sat writing chart notes in the nursing station on the evening before the surgery. He gave me a cynical smile. "Well, to each his own," he said. "I put my faith in Dr. X," he said, mentioning the name of the highly respected cardiac surgeon who would be heading Immy's surgical team in the morning. "I doubt he needs much help from Lourdes."
I made a note to myself to be sure to take the medal off Immy's gown before she went to surgery in the morning so it wouldn't get lost in the operating room or the recovery room. But I spent that morning in the emergency room as part of a team working on two children who had been thrown from the back of their father's pickup truck onto the roadway. By the time I reached the floor, Immy had been taken upstairs to surgery.
The surgery lasted almost 12 hours, and things had not gone well. The bypass pump, a relatively new technology, had malfunctioned for several minutes, and Immy had lost a great deal of blood. She was on a respirator, unconscious and unresponsive, in the intensive care unit.
On the day after the surgery, Immy's mother told me in a shaking voice that Immy's gown had been removed in the operating room and thrown into the hospital laundry. The medal was gone. Concerned, I called the surgery resident and told him what had happened.
"Perhaps you should tell Dr. X," I told him. He began to laugh.
"Don't be absurd," he said.
That night, I could not sleep. Back in the house-staff residence, I kept thinking of the lost medal and what Immy's parents had told me. At last, sometime after 2 a.m., I took some paper and wrote a note to Dr. X, telling him what had happened and how important the medal was to Immy's family. Folding the note in half, I dressed and went back to the hospital to tape it to the closed door of Dr. X's office. I had signed it, and on my way back to bed I began to worry. What if I had done something really foolish? If the surgical resident didn't care about such things, why should Dr. X?
When I returned to the hospital for the evening shift, I stopped by the intensive care unit to examine Immy and speak with her family. She was still unconscious. Leaning over to listen to her chest, I suddenly noticed a medal pinned to her hospital gown. Turning to her parents in relief, I asked if it was another one. "No," her mother said, "it is the same one that was lost." Dr. X had come that afternoon and brought it to them. I told them how glad I was that it had been found. "Yes," her father said, "we are too." Then he smiled. "She is safe now, no matter what happens."