Katie Remembered

I know this feeling all too well, I’m being rescued again, and no doubt the intentions are good, how could they not be? Someone is trying to help me find my way.

It’s my own fault, truth be told, I’ve slipped and allowed someone close to me to know my doubts. As a result I have been given an article cut out of some leading Jewish newspaper, authored by a well known Rabbi, who has, by no small chance, finally discovered the true nature of the world, why bad things happen to good people, and everything in between.

There was a time in my life when I would have simply read the article, absorbed the information, and filed it appropriately in my brain along with Jewish ethics, culture, rules and ritual; all part of the growing database of this here proudly educated Jew; but since meeting Katie, simple explanations have not sufficed.

I won’t be so bold as to say my spiritual life was flawless before fate had our paths cross. I had my doubts about specific doctrines or rituals, but surely human error in interpreting the divine was accountable.

And I was not so far removed from reality, even back in those days, as to be uncomfortably aware of my own strangeness; walking through the halls of the hospital with my Yarmulke on, in a completely gentile community. People often turned to look at me for a second too long or whispered in hushed voices as I came by. I was something of an anomaly but… wasn’t it a fair trade?

Did I not have the ancient wisdom of God’s chosen people in my grasp? Were the secrets of the universe not at my fingertips while everyone around me fumbled in the darkness, groping for spirituality in the wastelands outside of clear cut orthodoxy?

I wore my faith like a protective cloak, held tightly around my psyche, perpetually warming me to the idea that I was far better off than my surrounding companions. I was above them; leading an existence based on pure directives from the source of all that was and all that would ever be.

How odd I must have seemed to them. So different and yet exuding such powerful confidence. Such self assurance. It must have come across in introduction as I gripped attending physician Dr. Gregory Petrovich’s hand, looked him in the eye and told him, yes, I was ready for the work ahead, because he nodded with appreciation and welcomed me wholeheartedly. I studied his face as he motioned for an elderly nurse to come over and meet me.
I judged him to be in his late fifties, early sixties. His hair had receded to a point of widows peak midway on his forehead and was salt and pepper at the temples. His face was craggy, his teeth terrible and darkened, and his stalwart torso spoke to me of Russian ancestry and a youth of physical labor. He was rumored to be amongst the most brilliant and dedicated of the collective staff.
“Molly”, he said with a light accent, his tongue refusing to part with the last remnants of a his Slavic roots, “this is Ben, he will be joining us for the next six weeks.”
“Pleasure to meet you, Molly.”
She took my hand lightly and did not address me. She looked at me.
No.
She took me in. She assessed me then as if determining my worth by her own careful examination, judging whether or not I had the right stuff for the task ahead..
Molly must have been mid sixties, and old fashioned to boot. She still wore a nurses hat; an accoutrement long since left behind by the profession. From beneath it flowed straight white hair, carefully arranged , and sharp blue eyes.

I had heard of her through rumors and gossip. Some said she had been a young nurse in Vietnam, others claimed she was a Nun who had later become a nurse. I don’t know why legends cluster about some people, but I do know what made Molly so exceptional. She was one of those rare people who had found her calling. It was evident in everything she did. This was where she belonged in life. This was her appointed task. I can’t say what she gathered from looking me over, but I saw in her Divine providence, God must have meant for her to be here.

I had barely had a chance to put my books down in a corner of the unit when the buzz of secretaries and orderlies informed me that we had been alerted to trauma. Dr. Petrovich tossed me a gown.

“Get ready”, he said and stalked off to arrange the armamentarium of medicines and devices on a cart that Molly wheeled to the first curtain.

He needn’t have told me twice, I had at my disposal all the energy and stupidity of youth.

“What’s your next rotation”, my roommate had asked me the night before.

“Burn Unit”, I had replied matter of factly, not bothering to look up from my studies.

“Are you ready” ? he asked smugly, already having been there and back.

What the …? didn’t he see me reading the goddamned chapter for the fifth time?

Of course I was ready. My whole life was about being ready.

As I finished donning my protective gown, a stretcher bearing Katie Janson burst through the double doors.

Now, in all likelihood, my erstwhile reader, you’ve never seen a burn victim before, and neither had I. I was not prepared at that time nor will I ever be, and I will not cavalierly turn that fate over to you without warning.

Take from me now a word of caution and advice. Go somewhere else, find yourself an errand, read a bit of politics, go socialize at the office cooler.

If you have a gentle heart this is not for you, dear reader, why, even after several years of studying the most destructive forms of disease, it was not for me. I froze there in my tracks like a statue, struck dumb by the sight of something writhing on that stretcher that could only be qualified as human based on it’s past history. A barely audible whimper emanated from between it’s cracked and swollen lips. It was a gritty hollow sound, pushed from the burnt trachea it grated like a guttural consonant that could not escape the throat.

Even all these years later I am still agonized by the fact that my first reaction was not compassion, but horror. Horror at the…the thing that kept it’s charred and blistered hands stretched directly out in front of it as if still in the act of warding off the searing flames. Fingers blackened and charred through and through and sheets of skin hanging from extremities, it was almost too much to bear. There was no hair on the disfigured head, and the eyes were blistered shut. But, God help us all, if you looked closely enough, it was still a little girl.

Petrovich snapped me out of it.

“Ben, we need you”

I came back. One foot moved then the other. Medical knowledge replaced panic and fear. I joined in with Molly placing wet cloth over Katie’s charred body. The dissociated, calculating, medical part of my mind began its assessment. 90% full thickness burns…I calculated fluid loss rates and recalled infection statistics. I noted that Katie Janson was still too hot to touch.

Molly began speaking into the nub of what was formerly an ear.
“Katie, your safe now, your in the Hospital, and we are going to take care of you”

“I need a central line for fluid management”, Petrovich said, as cool as a cucumber, “And I don’t like the way the airway looks”, he noted pulling charred substances off her swollen tongue with a gloved finger.

“Were going to intubate right now.”

And so the battle for life began. We fought it for Katie without complaint, without coffee breaks, and with a vigor that only accompanies those moments in life where survival is at stake.

We plied her with antibiotics and poured in fluids, we monitored her breathing and electrolytes. We doused her with pain medications and paralyzed her with muscle relaxants so that she wouldn’t buck the ventilator. We performed emergency escharotomy surgery to save her arms and legs from the tight burn tissue that threatened to cut off her circulation.

We each prayed to our own Gods that long night and as day broke and the first rays of light beamed gently through the window, they were answered.

“Pulse and Blood Pressure stable for the past few hours,” I told Petrovich without need. He could have delegated responsibilities for patient care, but he had stayed by the bedside all night.

“Her airway is looking better,” he said, “let’s let her breath on her own…Molly, we’re going to extubate.”

We gathered about the bedside as Petrovich withdrew the tube and Molly turned off the slow drip of paralytic agent.

For a moment we waited in silence and then Molly bent closer still and talked to the gruesomely burnt tissue and open fissures that was once the face of a little girl.

“Katie”

Now Molly could easily be classified as elderly, and the nights tolls showed themselves in her voice, but she persisted.

“Katie breathe, baby, you need to take a breath.”

It wasn’t hokey.
It didn’t feel artificial.
Molly with her gray hair and steely eyes had that demeanor about her. She had talked people back from the brink before and she would do so again right before our very eyes.


“Breathe, Katie, you can do it.”

It started as a slow rumble, a grating noise deep in her chest that carried out to her throat and past her lips. Her chest moved with the effort, but the unmistakable rasp of air continued to flow.

“Breathe Katie”

She was doing it. By God ! She was really doing it. It was going to be the miracle story of the year. No one is supposed to be able to live through a burn like that. Especially not nine year old girls. The odds against are astronomical, and yet before our eyes Katie Janson thumbed her nose at statistics and bucked the tables listed in every textbook. Her will to survive was a force more powerful than science had yet calculated.

I actually heard myself laugh out loud before I gave myself permission to do so. I was glad for it though, because it was contagious.

Petrovich forgot himself in a brief moment of celebration and smiled wide enough for me appreciate the archaic state of Russian dentistry.

Even Molly allowed the skin in the corner of her eyes to crinkle.

Secretaries at desks and orderlies with brooms, stopped to take notice and move a little closer to the joy of one little girl the grim reaper would not claim this day.

We were men and women of medicine and science and we took a moment to revel in our own glory.

Petrovich slapped me on the back hard enough to assure me that I would not even have survived kindergarten in the former Soviet Union, and we savored the realization of the night’s hard earned rewards together.

But Molly leaned ever closer and was thus the first to notice that something was wrong, terribly wrong.

Katie’s breathing did not rise and fall with a normal tempo of respiration but continued steadily in a pitch that now began to rise in tone.


Molly looked confused at first and that got our attention, but as the pitch grew Katie’s fingers curled into fists holding the sheets, taught burnt skin cracking open over all her knuckles.

The noise she was making got louder.

Molly blinked twice.

“My God… she’s screaming…she’s screaming.”

As the last of the paralytic medicines faded from her blood stream, Katie’s eyes fluttered open revealing unseeing globes of pure white scalded tissue. She looked about frantically trying to ascertain her whereabouts. And now her cry for help was evident to all, filling the unit with the pain of a child trapped by fire

You see, dear reader, estimates had been made, and chances taken. We had to paralyze Katie for the breathing tube, and… without her reactions to guide us, take a guess as to how much medicine would be enough to take away the pain and not kill her in the process.

Gregory Petrovich, twenty year veteran of the Burn Unit, took a step back and turned a paler shade of Belarus as the shrill scream permeated the room.

“Morphine,” he said, his voice cracking.

Even Molly was too slow for him and he snapped his fingers in impatience, “Morphine !”

I, for my small part, fumbled the vial over to Molly to inject, and am thankful to this day that I didn’t drop it.

Katie’s scream trailed off as she lost consciousness and a single tear traced the aged lines on Molly’s face.

Dr. Petrovich was silent as he replaced the breathing tube. His face was stone.

How long had Katie been trapped in her own body, screaming in pain?

Did she ever know that she was in the hospital, or without sight or hearing, had she, in her own mind, been trapped in the building that killed the rest of her family all this time, screaming frantically for help.


No one had the heart to voice these questions. We busied ourselves with the medicine, but the brief moment of optimism had come and gone all too quickly. Katie’s vitals now fluttered dangerously. Her electrolytes became difficult to control, and with every passing hour she seemed worse.

We fought the good fight that day, and paid credence to neither fatigue or mounting despair. I ran laboratory tests back and forth, but the news kept on getting worse, dehydration, acidemia, electrolyte imbalance.

We all took turns talking to Katie now…Hang in there…Don’t give up…Your going to make it.
But Katie’s will to live was slipping away, I suppose she had grown tired of screaming for someone to help her, grown tired of waiting to be rescued, and her body could simply not overcome the damage done.


When Dr. Petrovich pronounced Katie dead that afternoon, I couldn’t help but cry a little. He covered her over with a sheet and walked over to Molly to put an arm around her shoulder.

Low man on the totem pole I knew my task before it was given to me and I found Katie’s Aunt resting on a chair in the waiting room. I woke her gently out of her slumber. And she looked at me with growing apprehension. My face must have said it all for she burst into tears immediately.

I had no prior training but I instinctively lied through my teeth.

“She didn’t suffer,” I said, “She was comfortable until she passed on.”

To this day, I don’t think she heard a word I said, the way she wept. She was inconsolable.

I stayed with her a while to comfort her.

On the table next to her was a picture of Katie. I picked it up. Blond hair, blue eyes, very middle America looking…and oh my…what a smile.

I try to remember her that way.


That night I avoided roommates and human contact. It had been 36 hours of hell and I longed for my bed. I took off my Yarmulke and put it on my night table. I stared at it feeling betrayal of the deepest sort.

Could I pretend to be spiritually satisfied with dietary and prayer laws of the utmost specifics, when I couldn’t begin to fathom the most basic tenets of Gods relationship and responsibility to human beings.

What kind of sick joke had been perpetrated on me, to be told that I could walk around with this funny hat and have the answers, when my most enlightened moment occurred to me this instant, as I understood that I didn’t know a goddamned thing.

What role could Katie’s suffering have played in God’s great cosmic plan ? And if it did have a role then what does that make God ?

I still believed though…despite the days events I still believed, hell, maybe I needed to believe, and I prayed that Katie had gone to a better place, away from pain; but I didn’t see how that would be likely given how little concern God had shown her in this world.

Thirty six hours of standing on my feet and fighting to keep my eyes open, and now lying comfortably in bed and… sleep would not come.

Now I sit here, many years later, with this article on my desk, getting ready to read about the harmony of our universe and how our benevolent God is watching over all of us. And that’s fine, I have an open mind, and I am ready to understand if a rational case can be made.

But before the answer must come the question, and I must remember this first brick that fell out of the previously impenetrable façade of orthodoxy that had been erected for me in Yeshiva. I have to remember the first time I realized that the answer was lacking, and needed, and nowhere to be found.

I’m going to read this article now, but I had to remember Katie first…