“He scares me. I’m an ICU doctor, and he scares me.” Those were the words spoken as James was being admitted to ICU on Friday. He had already been in the hospital for a few days, but now he was working much too hard to breathe and needed help right away, before things got a lot worse. He was on the maximum amount of vapotherm (heated, high-flow canula), so help this time would come in the form of intubation and a ventilator. This was the only way to give his little body a break and let it begin to heal. I never imagined the day would come where I, once again, would be at his bedside, watching oxygen saturation, blood pressure, and heart rate on the monitor over his head. It felt like a nightmare and I wanted so badly to wake up. James had not been this weak and this sick since he was born.

We were thrown back into a world with blood gases, PICC lines, art lines, vent weans, daily x-rays, NG tubes, blood cultures, ET tube cultures…and the list goes on and on. It was terrifying. “We’re doing everything we can.” “He’s not out of the woods yet.” “We will watch him very closely.” Statements were spoken that filled us with fear, questions and uncertainty. How would we get through this? How would James? And then old instincts kicked in. This is a world we know very well. We’ve got this. We slowed down and concentrated on the moment at hand. He was stable, and stayed that way. Then he required slightly less oxygen. Then he was starting to breathe over the vent. James was doing better than expected. We used our old tricks to comfort him, and let him know he wasn’t alone. James used his old tricks, and a few new ones, to show us he’s got a lot fight left in him.

James has made remarkable progress the last couple days, and we’ve adjusted to this world again. There’s nothing scarier than seeing him back on a ventilator, but our experience has given us some peace amidst the fear. We’ve learned having a critically ill child feels similar whether they are a tiny micro preemie in the NICU, or a two-year old in ICU. And although we were frightened of the uncertainty before us, we fell back into old routines and we’re getting through this one day at a time. Like a good friend said, it’s a lot like riding a bike.