Part one

Eli Callahan got better every morning.

At seven, when I started my shift, he’d be sitting up in his bed in Room 12, his red hair sticking up, watching cartoons on the hospital tablet. He’d ask me if we could play Uno. He told me his goldfish was called Fenway, like the ballpark, because his dad was a Red Sox fan.

His morning labs were almost normal. The attending wrote “improving.” There was talk of taking out his feeding tube.

He had been with us for nineteen days. He weighed twenty kilos fully dressed. On the door of his room, his mother had taped a paper dinosaur and a photo of him in his baseball uniform, at five, before all this.

And every evening, around 8 p.m., he started dying all over again.

The vomiting came first. Then the thirst, a terrible thirst that had him licking his cracked lips. Then the fever, the drowsiness, the eyes rolling back. The sodium level in his blood would shoot up all at once, to levels you almost never see in a child. Twice, we had to take him down to the ICU.

The next morning, he was better.

I should explain where I work, and what I am.

My name is Dana Novak, I’m forty-one, and I’ve been a pediatric nurse for seventeen years. I work on the fourth floor of a children’s hospital in the Longwood area of Boston, on the general medicine floor. I live alone in a second-floor apartment in a triple-decker in Dorchester, I work twelve-hour shifts, I catch the Red Line at 6:10, then the Green Line, and I drink my coffee from a paper cup with a lid that leaks.

Seventeen years means I’ve seen everything. Kids who get better, kids who don’t, parents who scream, parents who collapse in the hallway, parents who sleep for three weeks in a chair that folds out into a bed. I’ve learned to love the parents. They’re the ones who stay when I go home.

And Kristen Callahan was the best of them all.

She was thirty-four, with a perfect ponytail and a blue binder. In that binder was Eli’s entire medical life since birth, laminated, with color-coded dividers. The hospital stays in Worcester, in Providence, then in Boston. The tests. The diagnoses that had been considered and dropped. She knew all the terms. Hypernatremia. Diabetes insipidus. Osmolality. She pronounced them better than some of the residents.

She came every day from 4 to 7, after picking up her youngest, Harper, ten months old, from daycare. She carried her on her hip, with a big gray diaper bag slung across her body. She brought cupcakes for the nurses’ station on Fridays. She knew the names of our kids. She had sent a card to Rosemary, our charge nurse, when her husband had knee surgery.

“I don’t know what we’d do without you,” she would tell us. “You’re my family here.”

We never saw Eli’s father. They were separated. Kristen said he was a fisherman in Gloucester, that he drank, that he was “unstable,” and that she had asked the front desk not to let him come up. She said it with a dignified sadness. We felt sorry for her.

I felt sorry for her too. For three weeks.

What made me look up wasn’t her. It was Eli.

One afternoon, around 3:30, I was changing his feeding bag. He was looking at the door. He asked me:

“Is Mommy coming tonight?”

I said yes, of course. He nodded. Then he pulled the sheet up to his chin and didn’t say anything else. He wasn’t happy. He was resigned. Like a child who’s just been told he’s getting a shot.

I told myself I was imagining things. Sick kids are tired. Sick kids are allowed to be sad.

Then, at the start of the month, Kristen caught the flu. Unit rule: no visiting for five days with a fever. She called morning and evening, coughing, worried, perfect.

In those five days, Eli didn’t have a single episode.

He ate green Jell-O with a spoon. He won four games of Uno against me, by cheating. His sodium was normal morning and night. The doctor talked about a “delayed effect” from a new treatment. Everyone was pleased.

On the sixth day, Kristen came back, recovered, with lemon cupcakes. She stayed from 4 to 7.

At 8:15, Eli was throwing up.

I didn’t say anything to anyone. Because what I was thinking was monstrous, and because I might be wrong. A nurse who accuses a mother without proof, nobody forgets that. And she never gets over it either.

I know. Twelve years ago, I had reported a father who seemed too rough with his daughter. He was innocent. Just clumsy, exhausted, terrified. Because of me, he went three days without being allowed near his daughter. I had never forgiven myself.

But I started watching.

I watched Kristen close the door of the room “so Eli can sleep.” I watched the feeding pump, hooked up to the tube that ran through Eli’s nose down into his stomach. On the tubing, there’s a little purple port, for giving medication with a syringe. Anyone can open it. You just have to know where it is.

Kristen knew where it was. Kristen knew everything.

On the Thursday of the third week, at 6:40 p.m., she stuck her head out into the hallway.

“Dana, could you hold Harper for two minutes? I need to use the bathroom, and she screams the second I put her down.”

She put the baby in my arms, and the diaper bag on my shoulder. She headed off to the visitors’ restroom at the end of the hallway.

Harper smelled of milk and pee. She needed changing. I put the bag down on the empty bed in Room 14 and opened the main compartment. Diapers, wipes, a spare onesie, a bottle. I unzipped the little front pocket to find the cream.

There was no cream.

There was a sixty-milliliter syringe, with a purple tip. The kind that’s only good for one thing: connecting to a feeding tube. At the end, there were still a few drops of a cloudy liquid. And around the tip, a thin crust of white crystals.

Harper didn’t have a feeding tube.

It wasn’t a syringe for a baby.