The Little Hand Beneath a Blue Drape

It came to me again a few nights ago, as it has many times over the years. This time it wasn’t the full dream. Just a single image: a small hand protruding from beneath a blue drape. I awakened and lay there, replaying what had happened.

I’ve witnessed other tragedies in emergency rooms, on highways, and in Iraq. Some were just as awful, and far more graphic. But they do not haunt me like this one does. Maybe it was my inexperience at the time. Maybe it was because I had a child the same age. I’m not sure…

A young rural pastor had been invited to preach at a large urban church. He was excited, though worried about taking his wife and two boys, ages three and seven, into the city. They stopped for lunch along the way.

The three-year-old sat in a booster seat in the front passenger seat beside his father. His mother and older brother slept in the back. After parking, the pastor unbuckled his son’s straps. He opened his door, saw that he had parked over the line, and got back in to move the car.

In those few seconds, the little boy crawled onto the floorboard and found a loaded revolver beneath the passenger seat. His father had brought it for protection during the trip.

The gun discharged. The bullet entered the boy’s head.

He was airlifted to the university hospital where I was a brand-new third-year medical student, just weeks into my first clinical rotation: trauma surgery.

The initial assessments were grim. Further examinations confirmed that he was brain dead.

Counselors came. His parents consented to organ donation. Surgical teams from distant cities were notified and began to arrive.

The boy lay in a private room just off the pediatric intensive care unit. I was on call that night and found myself alone with him—just me, the steady beeps of the monitors, and the rhythmic hiss of the ventilator.

I reached down and touched his hand.

It was pink and warm. He looked alive. He certainly felt alive.

I thought of my daughter Hannah, the same age. How could his parents take in what had happened? How would they survive it?

In the early morning hours, the teams assembled for the organ recovery surgery. Still on call, I was asked to scrub in. A third-year medical student contributes little in such a case. I was there to observe, to learn. My only real job was to hold a retractor.

“Hold this.”

“More tension.”

“Push here.”

Space around a small child on an operating table is limited. I found myself wedged between a surgeon and a scrub nurse, my body turned sideways, my right hand tucked against my chest to preserve sterility, my left arm extended almost blindly into the surgical field to hold whatever needed holding.

I could see little of the operation.

But I could see his little hand.

It protruded from beneath the sterile blue drape, small and pink. I stared at it for more than an hour.

I wanted his fingers to move. To twitch. To flex. To do anything.

His heart was recovered last. The teams left with the organs, packed in coolers and bound for recipients in distant cities. The operating room emptied quickly, and once again I was alone with the little boy.

This time there were no monitors. No ventilator. Just silence, broken only by the sound of my own breathing.

I reached out and touched his hand once more—to say goodbye, I suppose.

It was cold.

Pale.

Still.