Lily, Part IV

Thoracotomy: an incision into the chest wall through the ribs, to enter the chest cavity.

I have seen three thoracotomies in my life; two were actually sternotomies (cutting open the sternum, rather than the ribs) for heart transplants from my cardiology rotation- one of those was recorded in detail on this blog. The third was an emergency thoracotomy I saw at 4:00am one morning in the ER, on a man dying after a traumatic motor vehicle accident. As Dr. Lovelace said: When you can’t figure out what’s wrong after imaging someone over and over, and they keep dying, all you can do is cut them open and take a look. Once we’d used the rib spreader to get that look, it was obvious that the man’s diaphragm had been severed and he was bleeding heavily from a laceration to his lungs. He passed just minutes after his thoractomy.

Point being: a thoracotomy is a big deal. Doctors don’t cut into someone’s chest unless they absolutely have to; its only done in the most extreme circumstances, and then only to save a life. Needless to say, cutting open Lily’s chest to remove the fungus was exactly that kind of heroic, life-saving measure; and those procedures are always the riskiest. Even though it wasn’t an emergency, it would still be incredibly painful and would also take her months to recover.

If she survived.

When Dr. Rooms approached Lily’s parents with the options, I don’t know whether or not they fully realized the gravity of the situation; but regardless, when everything had been explained… they decided to take their chances, and go with thoracotomy.

I don’t have children, and I always think about how unimaginable it would be to make the kinds of life altering decisions our parents are often being forced to make. But one thing I’ve learned from them is that anything is better than letting your child die, and then wondering later if they might have been saved. That is the unbearable thought that trumps every other medical risk or procedure, no matter how horrifying; and rightly so.

At ten a.m. the next morning, I stood in the hallway of the bone marrow unit and watched as the transporter arrived to take Lily to the OR. She looked much too ill to be undergoing this kind of surgery; her mom was waiting to get in the elevator to go down to the OR waiting room. She caught my eye and so I walked over and tried to reassure her with a hug and a smile, and let her know I was praying for her and for Lily.

But inside I wondered if she would ever see her daughter alive again.