Neil and Peggy Two of Lia’s doctors

1. Neil and PeggyTwo of Lia’s doctors

2. Neil’s reaction to Lia’s “Big One” • Page 143 • Neil’s pager went off at 7:35. He and Peggy were eating dinner with their two sons. He was told that Lia was in prolonged status epilepticus, that no one could get in a coded IV, and that the Valium wasn’t working. “As soon as I heard that,” he recalled, “I knew that this was it. This was the big one.” • Neil had been afraid for months that when this moment came, he would be the one on call, and he was. • “It was an incredible scene,” Neil said. “It was like something out of The Exorcist. Lia was literally jumping off the table. She had restraints on, but her motor activity was so unbelievable that she was just jumping, just hopping off the table, just on and on and on and on………I remember seeing her parents standing out in the hall, just outside the emergency room……..They must have seen everything. I caught their eye a couple of times but I was too busy to talk to them right then. We had to get in a more substantial IV and there were the usual problems- her fat, her sclerosed veins from previous IVs- only worse this time because of her absolutely tremendous muscular activity……The atmosphere in the room was just charged. And he got it! And then we gave Lia just a ton of medicine, a lot, and a lot, and a lot. And finally, she stopped seizing. She finally stopped. It took a long time, but she finally stopped.” • I had never seen Neil so upset as he was when he told me this. When Neil finished talking, I could hear him breathing- not heavily, but audibly, as if he had been interrupted partway through his morning’s eight-mile run. • This was Lia’s sixteenth admission to MCMC.

3. Neil turns to Peggy • After Lia’s vital signs were stable, Neil walked slowly out into the hall. He had sweat stains running from his armpits to his waist. Using the English-speaking nephew as an interpreter, he explained the situation to Foua. “I told her that this had been the big one………..I told her that Lia would need stuff that Peggy and I couldn’t do. I also told her that we were leaving town but we would be back next week.” • After he had arranged for an ambulance to take Lia to Fresno, Neil drove home. He told Peggy, “That was it. She did it this time.” The two of them talked until almost midnight retracing every moment of Lia’s crisis and each of Neil’s decisions. “I was so fired up,” he recalled, “I just couldn’t come down. When I’m like that I have trouble sleeping, and I start food-cramming- I just start stuffing stuff in my mouth. And I have to tell Peggy all about what happened.” • “That night my feelings were mixed,” said Neil. “It had been just like my nightmares-that Lia would have the most terrible seizure of her life and it was going to be my fault because I couldn’t keep her from dying- but she hadn’t died, and with some real capable people helping, I stopped it and I took care of it and I was able to meet the challenge. So I felt a certain amount of satisfaction. But I also felt terrifically sad because I didn’t know what Lia was going to be like when she came out of this. I was pretty sure she wasn’t going to be the same.”

4. Your thoughts • Groups 1 and 3 • At this point in Lia’s medical care, how would you describe Neil’s emotional reaction to Lia’s condition?

5. Lia was sent home to die. • After Lia was transferred back to Merced…………… • Page 172 • I turned to Neil to ask what his impressions had been. He shifted uneasily in his chair. “Well, I didn’t see her right away. I knew she’d been transferred back to our care to die. There she was, and that was what I had been afraid of, and I was just so- I mean, that episode in the emergency room burnt me out, it emotionally drained me, and facing Lia was real difficult for me at that point. • “So I took care of her,” interjected Peggy. • “You did. I mean, you probably took care of her almost exclusively. I probably chose to avoid it a little bit. More than a little bit. I chose to avoid it. I have to admit, I bailed out.”

6. Neil remembers • Later after everyone had been waiting for Lia to die…………………………………. • Page 213 • The first time Lia returned to the clinic for a checkup, Neil was on duty………………… “That first visit was a very significant visit for me,” he said. “It was very emotional. I remember Jeanine Hilt was in the room too. Also an interpreter. I remember talking to the mother and saying it was very hard for me to see Lia the way she was, to actually be in the same room with her, and that what had happened was something I had always feared, and that I was very sorry. And what absolutely blew me away is that I, well, I was afraid they were going to blame me for what happened, but the mother showed me compassion. She understood-somehow she got the-she, well”—Neil was scrabbling uncomfortably for words, but he was determined to forge ahead- “well, I think part of it was that I was crying. What she did was, she thanked me. And she hugged me. And I hugged her.” He cleared his throat again. “So anyway.”

7. Did Neil “Bail”? • Groups 2 and 4 • Reflection: What reaction did you have to Neil’s intentional separation from Lia’s case? Is your opinion of Neil different now?

8. Your sanity link • Everyone please respond • While considering education, we don’t have the luxury of separating ourselves from a difficult situation with a student. When you are faced with working with a student who does not respond to your teaching strategies or efforts to connect with him or her, discuss how you deal with this emotional rollercoaster ride. Neil used Peggy as his link to sanity. What works for you?