The Legacy of Casey McQueen

Casey McQueen hears soft throaty purrs and peeks out of one eye - her mother, Mia, finally falls asleep. Sometimes Casey pretends to be sleeping so her mother will allow herself to sleep too. Even eight months pregnant, Mia insists on taking the night shift to stay by Casey's bedside - just in case she's needed...or something happens. David, Casey's devoted Dad, always comes back to give Mia a break at the crack of dawn.

Casey slips her hand under her stiff, sterile pillow and feels around for her sketch pad and charcoals. She brings them out and gingerly weaves them in and around the various tubes connecting her to the life-sustaining equipment that has imprisoned her to a bed for the last two months.

Born with heart disease, Casey is quite used to the hospital and knew, one day, she'd need to make it her home. She's had six operations in her very short seven years to help her big, but failing heart, function. Two months ago she came in for a routine check up and has been here ever since. Operations won't help anymore. She needs a new heart. So, here she'll stay...waiting...as the heart monitor beeps, the EKG strips click and the oxygen hisses - together playing a symphony of hope.

Casey fingers through the book bulging with sketches to find her latest masterpiece. It's a secret surprise for the new baby to come: a glimmer of joy amid the chaos. As she starts to scratch the page with her tools, Mia stirs.

"You should be trying to get some rest," Lois, her night nurse, whispers.

"I'm not tired," Casey sniffs. "Besides, I need to get this part done while I'm inspired."

Lois rolls her eyes: "Our own little Rembrandt. Lemme see."

"No," Casey throws her unrestrained arm across the page. "I've barely started. And it's a surprise for my little sister."

"Oh, Casey," Lois squeals. "I didn't know your Mom knew the sex. How wonderful."

"She doesn't know," Casey shakes her head. "She didn't want to...but I know. I just know it has to be a girl..." Casey starts coughing then wheezes.

Lois looks at the monitors then frowns. "Still got that cough, huh? We'll have to tell Dr. Philmore."

Casey clicks her tongue: "But he'll just up my meds and I won't be able to work. I have to get this done."

"Case," Lois touches her face. "Ya wanna get better, don't ya?"

Casey's attention reverts back to her sketch and whispers: "You know that's not going to happen, Lois."

The nurse opens her mouth to speak but shakes her head. She checks Casey's vitals then slips out without Casey noticing. Casey hunches over her drawing working by the only light in the room - a spit of light peeking over from the small cupboard beside her bed. Her hands fly around the page like an edgy chipmunk. Her fingers blackened by the charcoal from smudging the lines into the fibers of the page to create her ghostly image. As she sits up to admire her work, her cough ravages her body.

Mia bolts awake and rushes to Casey's side. Her eyes dart from her daughter to the monitors. Finally she starts pounding on Casey's back with one hand and thumbing the call button with the other.

Charcoal pieces fly off the bed and the sketch book hits the floor as Casey thrashes around - trying to fill her lungs with air. Like a scene out of ER, the room fills with light and flashes of white coats as nurses and Dr. Philmore rush in to save Casey. Casey raises her free arm to Lois and points to the floor. Snaking through the legs on the floor, the nurse rescues the sketch pad and shoves it back under Casey's pillow. Casey smiles under the oxygen mask and blinks at the nurse who pats Casey's arm in response.

After several minutes, Casey's chest rises and falls in short, wet, congested gasps then into somewhat of a rhythm. Dr. Philmore, his forehead damp with sweat, turns to Mia: "I think we're going to need to do more X-Rays of Casey's chest."

Mia - still frozen with her hands over her mouth - nods her permission. As Casey is wheeled from the room, Mia's hands slide down to her belly. An unidentifiable body part pokes out from her side to offer comfort. Mia crouches down to pick Casey's charcoals up and sobs like an infant The strong but gentle hands of David blanket her shoulders as he eases her up. They cling to each other until Casey is brought back to her room.

"Well," sniffs David. "There's my favorite girl. Stop scaring us like that, ok?"

Casey coughs a small laugh at her Dad. She tries to speak but David waves her quiet: "No, Case. We'll talk later, ok? Have a rest then you can give me an art show later."

Casey winks then nods off. David has always been supportive of Casey's artistic ability and encourages her to create. Since she was four, she's been able to create artwork far beyond that of her peers and it's given her strength in the roughest of times.

Dr. Philmore waves Mia and David into the hall - leaving the door ajar for Mia's peace of mind.

"The results of Casey's chest X-Rays aren't good," he speaks to Casey's chart. "I'm afraid the infection she developed has spread to her lungs. She has double pneumonia."

Mia's lips part to ask questions but could only squeak. She grabs David's arm and he takes over: "In a nutshell, Dr. Philmore. What does that mean?"

Dr. Philmore closes Casey's chart then inhales: "It means Casey's in a lot of trouble. Frankly, even if a donor comes available at this point we wouldn't be able to operate on her - she's too weak. The infection has spread so much the medication we have her on isn't working anymore and her body is too run down to fight. All we can do is up her medication and make her comfortable...and pray."

Mia buries her face into David's chest. David nods at the doctor who gives instructions to the nurses then disappears down the hall. Mia wipes her face off then goes back to check on Casey. She's awake.

"Casey," Mia sputters. "Put your mask back on. You need some help breathing..."

"Mommy," Casey wheezes. "I heard the doctor. You guys should really shut the door and walk down the hall if you don't want me to hear your conversations." She tries to laugh but grimaces. "Mommy, don't be sad. We all knew this would happen - even if we don't talk about it."

"Honey," Mia tries to stop the conversation. "We should just let you rest. Here, let me put this back on..."

"No, Mommy," Casey weakly waves at her. "I'm not a baby anymore. I know what's happening to me and I'm not scared. Please...please just take care of my baby sister. I have something I need to finish for her. Something special. I won't go until it's done."

Mia starts to tear up: "You aren't going anywhere, baby. Please don't talk that way..."

Casey puts her hand over her mother's - her piercing blue eyes full of life her body doesn't have anymore: "Oh, Mommy. Stop trying so hard to fight something that can't be stopped. I don't. Everything will be ok. I promise."

"How did you get so strong?" Mia whispers.

"You and Daddy," Casey whispers back. "I think I feel ok to draw for a little while. Can you grab my book for me?"

Mia kisses Casey's hand then reaches under her pillow to retrieve Casey's sketchbook. As she places the treasure on Casey's belly she says, "You'll need some more charcoals, baby - the others are all broken. I'll get some today."

Casey holds on for two and a half weeks - sketching, smudging, wheezing and coughing. The medication helps her sleep but it only masks the inevitable. Then one evening during a quiet, uneventful visit - at thirty-six weeks - Mia's water broke.

David presses the call button and two nurses take Mia to the Birth and Delivery ward two floors up.

"I have to go for a bit, Case," David hyperventilates. "But I'll be back soon."

"I love you, Daddy," Casey beams. "Tell Mommy I love her too."

As Casey puts the finishing touches on her masterpiece she stares at the bleach white wall and mutters, "It's time." Then she falls back onto her pillow and convulses.

Lois drops Casey's chart and screams: "Dr. Philmore! Code Red! Code Red! Casey's going into shock!"
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Up in Maternity, Mia has gone into full labor. She'd been experiencing pains but they were so mild she didn't even associate them with labor. She was now ten centimeters dilated and ready to push.
"I see the head, Mia," the OB/GYN says. "Bear down...hard..."

**************************************************

"Begin chest compressions, nurse," Dr. Philmore orders as he jabs a needle into Casey's IV.

"Her BP is falling rapidly, Doctor," the nurse pushes on Casey's chest. "She's not responding."

"Damn it," Dr. Philmore mutters under his breath. "Get the paddles. I can't just let her go."

**************************************************

"Oh Mia," David weeps. "I can see the head!"

"Stop pushing, Mia," the OB/GYN fires out. "The cord is wrapped around baby's neck. Just pant until I tell you to push again."

Mia pants - for what seemed like hours - then hears: "Nurse, get the vacuum. This little one needs us to help it out. Hurray!"

*************************************************

"Clear," Dr. Philmore yells.

Bzzzzzzzzzzzzzzzzzzzt!

Casey's body jolts as the electric shock plunges into her body.

The nurse shakes her head as the straight line on the monitor mocks them.

"Up one more," Dr. Philmore orders. "Clear..."

Bzzzzzzzzzzzzzzzzzzzzzzzzt!

************************************************
"Ok, Mia, push," the OB/GYN urges.

Mia's pants turn to grunts as she bears down with all her strength.

"A really big push now, Mia, go..." the OB/GYN smiles. "C'mon...push, push, push, push...that's it, Mia! One more big push should do it..."

************************************************

"Nurse, please call it," Dr. Philmore mumbles.

"Time of death," the nurse sobs. "8:15 p.m."

************************************************

The room fills with the glorious first wails of a newborn baby girl. Mia and David cry in unison.

"Time of birth," the nurse barks. "8:16 p.m.

************************************************

A month after Casey died, life goes forward. Mia peeks into the pink and white frilly room she couldn't bear to even walk by a few months ago and is greeted with a gummy smile from baby Cassandra. There's an empty bed in Cassandra's room but Mia isn't sad. Casey's weak heart never dampened her strong spirit and lives on in her beautiful art.

"Let's go get something to eat, Sunshine," Mia purrs.

As she bundles Cassandra in her arms, Mia pauses to admire the piece hanging over the baby's crib: a charcoal still life of a newborn wrapped in blankets. In the right hand corner of the picture is Casey's signature. And a reminder she'll never really be gone:

"Baby Cassandra" - The Legacy of Casey McQueen.