Kira and the Gold Coin

It’s five thirty on Saturday evening, and Kira is hanging upside-down and backward over the edge of the sofa. This is entirely typical.

I’m sitting nearby with a book on my lap, relaxing by the lights of the Christmas tree in the corner. I’ve been chipping away at this book for a few weeks now – it’s a thousand pages long – and I’m down to the final fifty pages or so. Outside a winter storm is shifting into high gear, but in the living room I have achieved a nearly perfect state of domestic peace. The kids are playing, Kate is watching Kira with amusement, and the heating pipes are making that comforting gnomes-hammering-behind-the-walls sound that connotes a snug warmth.

That’s when Kira stands up straight, makes some choking sounds, and announces she’s going to throw up.

I’m saddened, but not alarmed.  She’s on the tail end of a pernicious virus, one of those horror-shows that results in liquid coming out of every orifice she has. We thought she had it licked, but apparently not. Filled with concern about keeping vomitus from the carpet, I hustle Kira into the bathroom so she can evacuate herself as hygienically as possible. Which she does.

Even when she starts complaining that something is stuck in her throat, I don’t panic.  I’m sure it’s simply that some piece of stomach matter has scratched her esophagus. I bring her a glass of water to help rinse the acidic taste from her mouth, and (I hope) soothe her throat a bit. 

“It feels like something metal is stuck in my throat,” she croaks.

That’s extremely unlikely, and I tell her as much. “Why would something metal be in your throat? That doesn’t make any sense.” 

“Because I swallowed a gold dollar coin,” she says.

My brain doesn’t really process that right away, and when it does, it ranks “literally true” as the third most likely descriptor for Kira’s pronouncement.  First is “she’s kidding,” and second is “she’s lying.”  Kira is a good kid, but she shares the trait of ‘unreliable narrator’ with so many young children. Also I’m at a loss to imagine that a gold dollar coin was anywhere near the sofa, or that Kira, at six years old, would have put it in her mouth, let alone swallowed it.

I press her for the truth, but Kira is insistent, and she’s usually quick to admit the truth of things when she knows the jig is up. So I ask her, “why was there a coin in your mouth in the first place?”

“I have a bad habit,” she explains. “I like sucking on coins.”

She speaks the phrase ‘bad habit’ as though it’s a sovereign shield against recrimination. She can’t help herself! It’s a habit! My brain is now thinking that Kira has regularly been putting some of the germiest, filthiest objects in existence into her mouth. How have I not noticed this?  From there it’s a quick and slippery slope to ‘How can I have been such a bad parent?’ Sure, other kids put things in their mouths that they shouldn’t, but those kids are all less than three years old. Kira is six! If I haven’t managed to inculcate her with enough sense not to put large solid non-food objects in her mouth, what else have I failed to teach her? Not to stick metal forks in electrical sockets? Not to drink laundry detergent? Not to put her hand down the garbage disposal?

Parenthood has just been one long trap, lulling me into thinking that I was a grown-up with a grown-up’s sense of responsibility. Look! I’ve managed to raise to kids to the ages of six and eight without them suffering any permanent physical harm! But now that thin and wavering illusion is rippling away. Behind the veneer of teaching Kira to read and do math and play chess, I have failed at a much deeper level. And thanks to my failure to provide any knowledge of how the world actually works, my beloved daughter is now gagging over a toilet and complaining that she’s having a little trouble breathing. Because she swallowed a dollar coin.

I waste a good two minutes calling her pediatrician, but it being a Saturday night I get the answering service. The physician on call will get back to me, soon, they hope. At least I have the sense not to wait; I bundle Kira into her coat and shoes, hand her a bucket since she’s still bringing up gobs of saliva, and hustle her out to the car. Kate, my fantastic wife, whose main fault right now seems to have been leaving her incompetent husband to do the bulk of the domestic kid-raising duties while she earns the family’s living, stays behind. Several days earlier she threw out her back and can move only slowly, and even then with significant pain. It only makes sense that she stay with our older daughter while I drive through the blizzard to the emergency room.

Kira is in the back seat constantly spitting into her bucket. She can’t bring herself to swallow; it hurts too much. I keep her talking, because if she’s talking then she’s breathing, and it’s hard to keep worst-case-scenarios out of my mind right now. The minivan skids a few times en route to Winchester Hospital, but we make it, grab one of the rarely-achieved parking spots right by the emergency room entrance, and head inside. (I stop to empty her bucket into an outdoor trash can; it seems poor form to bring a pail of germy spit into a hospital.)

In my past experiences with the E.R., if you’re conscious and not carrying one of your own limbs, you’ll probably get triaged to the back of the queue.  But the doctors seem to regard our situation as dire enough to get her x-rayed immediately, which is both gratifying and worrying. It’s not long before a nurse comes to tell me the news.

Yup. She sure did swallow a big honking coin. It’s lodged at the base of her throat, not having decided yet whether to head for her lungs or her stomach. The good news is, it’s angled edge-wise to her breathing pipe, and so is not seriously restricting airflow. The bad news is, it could easily shift around and become such an obstruction, and obviously that would be quite grim. They recommend that it be removed as soon as possible. But they can’t do that at Winchester, so we’ll be put ASAP into an ambulance and taken  to Children’s Hospital in Brookline, 20 minutes away in good weather.  Have I mentioned that half a foot of snow is falling on the Greater Boston area right now?

Kira takes it all with a calm and curious equanimity so endemic to her nature. The ambulance driver lets her choose whether we’ll drive with sirens blaring or not, but Kira plays it cool, says it doesn’t matter, and the driver can choose.  She just thinks it’s neat that we get to ride in an ambulance. As we’re whisked down the highway, she chats with the EMT, a friendly fellow with kids of his own, and explains about her ‘bad habit’ of sucking on coins. Not wanting the EMT to think I’m condoning this behavior, I jump in. “Kira, that’s a habit you have to break. I want you to promise me you’ll never put anything in your mouth again that doesn’t belong there.”

“I promise.”

I’ve already made her promise this several times since leaving the house. I still haven’t come to grips with the fact that I hadn’t pounded this into her head hard enough to stick, back when she was three.

Then the EMT says something that proves to be the most important thing Kira is going to hear throughout this entire ordeal.  “I bet once they get the coin out, you’ll get a Popsicle.” Kira locks in on this with the single-minded focus only kids can achieve. She has found her brass ring, the Holy Grail of rewards. She asks some questions about the Popsicle, regarding flavor, color, and how many hours from now she will have it in her possession.

Upon arrival at Children’s, we are escorted to a hospital room and Kira is hooked up to a pasta factory of tubes and wires. Since she’s not allowed to eat or drink anything before the procedure, they put her on an IV drip to prevent dehydration. She’s not happy about the needle but endures it with good grace. A movie-set Hospital Machine shows several rows of blipping lines, measuring her heart rate, oxygen level, blood pressure, and a couple of other mysterious life-sign indicators. They’re still most concerned about her breathing, though there’s no sign of trouble there at the moment.

A bewildering parade of doctors and nurses marches into the room over the next few hours. Kira diligently quizzes each of them about her Popsicle, before they ask me their standard batteries of questions: what exactly happened? How long ago? Is Kira currently taking, or allergic to, any medications? Is she generally healthy? Eventually I have the spiel down so pat I could deliver it at a comedy club, though this is equal parts comedy and tragedy.  Before we’re done, I know it’s going to tip fully one way or the other.

Along with the visits from seventeen medical professionals, I have to sign an equal number of waivers and release forms, most of which involve giving consent to the hospital to remove the dollar coin, as if there’s a possible universe where I’ll say ‘nah, let’s not bother.’ They’ve explained to the procedure to me, which is quite simple.  They’re going to sedate Kira, reach down her throat with something that’s effectively a giant pair of tweezers with a mounted camera, and pluck out the offending currency. I ask how likely anything is to go wrong, and am told “Almost zero. Less than 1%.”  The more numerate among you will recognize the vast probabilistic gulf between those two estimates, but surely if there’s one thing children’s doctors are good at, its removing objects from kids’ throats.  And heck, won’t Kira’s case be easier because there’s more room to maneuver? You know, because she’s twice as old as every other patient who needs this done?  Oy.

Among all the talks and assurances and assessments and paperwork , it’s hearing from the anesthesiologist that gets to me. He talks about Kira’s sedation, how they won’t knock her out fully, but only mostly, before they go treasure diving. When he talks about risks he divides them into two categories.  The first is “things that are very serious, but also very unlikely.” These mostly include outcomes wherein Kira stops breathing for some significant length of time. He describes the likelihood of these as “one in the fifties or hundreds of thousands.” He busts out the oft-used comparison that Kira was in much greater danger on the car ride to the hospital.

The second category is for things that are less serious but much more likely. As in, 15-20% likely.  The most common of these is that Kira will, upon waking, achieve a state of delirious hysteria, panicking and screaming and probably not even recognizing me. I appreciate the warning, but I’m still trying to think of comparative occurrences with 1 in 50,000 chances of happening.  My numeracy is being sorely tested. My rational mind is fine with those odds, but my Irresponsible Parenting Mind is pointing out that people win the lottery every day, and get struck by lightning and meteors and satellite debris and goodness only knows what else falling out of the sky with worse than 50k to 1 odds.

I sign the anesthesia consent forms, and now we wait. At some point Kira stops spitting into her bucket, and we’re able to have real conversations. I casually mention that, ha ha, I’ll bet she’ll never eat another coin again, huh? She nods, and complains that it’s uncomfortable drinking through her arm. Kira is an amazing kid who seldom complains, and this whole trip is no exception, but she does mention quite often that she’s annoyed by the IV needle.

We pass the time by playing 20 Questions, and “guess the number between 1 and 100.”  The nurse comes in and tells us, apologetically, that Kira’s procedure will be delayed, as another patient has come in with life-threatening injuries.  She brings me a bottle of water, since by now it’s about 10:00 P.M. and I’ve had nothing to eat or drink since noon.  Around 11:00 we learn that yet another imperiled child has arrived, and there’s still no word on when Kira will get her extraction. A nurse keeps Kira company while I nip around to the in-hospital Au Bon Pain for a belated dinner. I inhale about 1500 calories of roast beef sandwich and a few bready confections. Kira must be starving, but she makes no mention of it. She’s willing to watch me eat in front of her because, as she reminds me, she’ll be getting a Popsicle pretty soon.

By midnight Kira has fallen asleep. My eyes flicker from her face to the beeping, hopping lines on the Hospital Machine, particularly the one measuring her oxygen levels. Her face is peaceful, her be-tubed arm dangling off the side of her hospital bed. I realize that I have never been so annoyed with, and sympathetic toward, the same person at the same time. It’s a state I think only parents can achieve.

It’s 1:30 A.M. when the nurses come to wheel her into ‘surgery.’  It’s not actual surgery, since they’re not cutting her open, but it’s a serious enough business that surgeons have to perform it. Kira wakes up en route, and I tell her everything will be fine, that the doctors will have that coin out in no time. She tells me her favorite flavor of Popsicle is bubble gum.  Then she goes one way and I am obliged to go another, into a large waiting area.

A young couple is there, watching TV.  Next to them is a pile of clothes and bags heaped on an infant car-seat carrier. I wonder if their child is one of those who came in with a more serious affliction than my own. It seems rude to ask, so I just nod and sit some distance away. My situation snaps into a saner perspective; here are parents with a baby in surgery. They’re probably still in that addled state of sleep deprivation and new-baby angst, and now they have to deal with a hospital-worthy health crisis? Kira’s money-gulping woes suddenly seem less awful.

I watch the TV to take my mind off of things.  The young couple seems engrossed and so I don’t change the channel, even though what I’m watching is some kind of insipid “mansions and millionaires” show full of quick camera pans and excited real-estate-agent sound bites about multi-million dollar properties and the celebrities who live in them. The commercials are worse. Surely the existence of a Duck Dynasty beard-growing Chia Pet heralds the downfall of our civilization.

Abruptly, I realize that over an hour has passed since Kira was wheeled away. Being a Bad Parent, I never thought to ask how long I should expect the foreign body extraction to take.  The way they described it, I imagined it would take about 3 minutes. Tweezers go in, make their grab, come back out.  Like a sword-swallower doing a quick demo of their art. How could this be taking an hour?  Unless… unless something has gone wrong, of course. My composure, weakened by guilt and sleep deprivation, disintegrates. I start pacing and looking at my watch every fourteen seconds.

At 3:00 A.M. one of the doctors comes into the waiting room bearing a plastic medicine bottle. He smiles, walks to me, and hands me a cylinder containing a tarnished John Adams gold dollar coin.  “We ended up removing it from her stomach,” the doctor tells me. “It must have dropped down when her throat relaxed from the anesthetic.” I suppose those tweezers were longer than I was picturing. I am taken to yet another hospital room where Kira, freed at last from her numismatic obstruction, slumbers peacefully.

A nurse is fiddling with her I.V. drip. They have some fancy machine that monitors its function, and this is beeping a constant alarm that there’s air in the tube. She calls in another nurse and they try a number of fixes to this problem. None of them work. I’m so amped up on adrenaline and worry that I’m certain they’re injecting deadly air bubbles directly into Kira’s veins, but the nurses don’t seem worried. Eventually they disconnect the thing and we all travel down some corridors and into an elevator, then up to the fourth different hospital room of the day.  Kira wakes up en route, and the first thing she says is not “Hi daddy” or “Did they get the coin out?” It’s “Do I get my Popsicle now?”

Ensconced in our recovery room, she is finally given her reward, a double-stick grape-flavored Popsicle. She immediately gets down to the serious business of consuming it, savoring it lick by lick over half an hour.  When she’s done, I dispose of the wrapper and stick, make sure she’s comfortable, and we both go to sleep.

An orderly knocks at 8:30 and brings Kira a big pancake breakfast. She eats three Frisbee-sized pancakes and sucks down four juice boxes. I keep thinking she won’t be able to finish, and that I’ll be able to scavenge some leftovers, but this is a fool’s hope. She hasn’t eaten anything for over 20 hours.  But my hunger pales next to the joy of seeing her eat (not to mention breathe) without discomfort. We watch some cartoons and the middle section of A Bug’s Life while we wait to be discharged. Kira is quite happy with this arrangement.

Sometime around 11:30 we are released from Children’s Hospital, which has paid for a cab to take us back to Winchester Hospital. There I find, as expected, that the minivan is effectively a glacier with wheels after sitting out in the storm all night. Kira gets comfy in her car seat, I turn the interior heat on, and spend the next fifteen minutes chiseling away the ice until a car emerges. I’m fairly well exhausted by now, not to mention exasperated, not to mention giddy that my daughter did not choke to death. Since Kate’s injured back prevents her from putting on socks, let alone shoveling snow, I realize that when I get home I have several hours of shoveling ahead of me.  But lo! My wife, a Goddess among wives, has paid $38 to a plowman for the removal of the polar bear’s share of the snow and ice. All that’s left for me is about 45 minutes of ice-breaking to remove the bottom layer.

And after that?  I come inside, eat some leftover Chinese food that Kate has set out, and then start wrangling Elanor, who needs to get dressed and ready for a piano recital that afternoon.

Because parenting doesn’t stop, no matter how tired you are.

I feel like I should have learned some valuable lesson out of all of this, besides the obvious one about doing a better job of teaching my kids about not accidentally killing themselves. I should be embracing platitudes like “Appreciate what you have,” and “Life is precious.” But mostly I’ve just been reminded that Parenting Doesn’t Stop. It’s an endless Super Mario side-scroller where we spend 18 years or more jumping with agitated desperation from one moving platform to the next, dodging monsters and grabbing all the coins we can.

Don’t swallow them.

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