Fiona’s death was a sudden death, unexpected and shocking. She attended school the entire week before she died. On Tuesday she had a fever of 99 degrees, but she seemed to just have a slight cold. Her teacher later confirmed to me that Fiona’s health seemed perfectly fine that week. Class pictures were Wednesday and she is front and center, smiling shyly. Soccer practice Tuesday and Wednesday night, coached by Ryan, with lots of fun, laughing and running. Thursday Fiona told me a boy went home from school that day due to vomiting; the flu was going around the school. Swimming with mom and sister Friday night, followed by ice cream as a reward for completing chores unasked. Saturday she didn’t feel well, lazed about the house and had a fever of 103 which was reduced with Ibuprofen. She skipped her soccer game that day, but asked for a sleepover with her Nanny that night, which we thought better of allowing. She ate dinner that night with the family, pork tenderloin and veggies. It would be the last meal I’d cook for her. It took many many months before I’d be able to cook a meal again, knowing she wouldn’t be eating it.
At 4 am Sunday, Ryan heard her crying and went to investigate. She complained of an abnormally bad headache. Her temp was 103 again so Ryan gave her more Ibuprofen and she went back to bed. I did not sleep much after that; I felt uneasy. At 7 am she woke up again and had gotten up to get a facecloth soaked with warm water. It was the only thing that brought some comfort. At one point she said, “Why do these things always happen to me?” It was the last full sentence she said in her life; I hope she got a satisfactory answer to that question. I wish I did. We decided to take her to the walk in clinic at St V’s which opened at 9 am. She vomited before we left, and once in the car and a third time in the hospital parking lot. They decided to admit her to the ER as at that point she appeared dehydrated. In the ER she received a stronger pain reliever, anti nausea meds, IV fluids, and fever reducer as her fever was now 104.2. Her heart rate was elevated because of the fever. A rapid flu test was administered and came back negative. Blood culture was taken to be analyzed. A chest x-ray showed no signs of infection. No signs of meningitis were found. White blood cell count was slightly low but nothing unusual. A pediatric intensivist was called to consult; it was decided she would be moved to the Pediatric unit to monitor the fever and fluid intake and output, and slowly resume drinking and eating. Vomiting had stopped and her fever abated.
She seemed relieved to be in the Pediatric unit, in a private room. We watched her favorite movie, National Treasure, and some lunch was ordered (pasta), which she did not eat. But she did have a few bites of pudding, a cracker or two, some juice and two popsicles. A second movie, Cinderella, was started, but we only got half way through before she looked very tired and no longer interested. The blood test results came back, testing positive for Influenza A, H1N1, which surprised me as she’d had the flu mist vaccine. Tamiflu was administered and contagious disease steps put in place; a sign on the door and full gowning up by nursing staff when they entered the room. We decided not to have family come visit since she was contagious; it was not encouraged. She had a slight hive-like rash, some puffiness, and was itching her eye around 4 pm; I asked the nurse about it and she said it was due to the IV fluids and the fever. The medical staff assumed she was resting and recovering from Influenza A and would be going home sometime in the morning, and would miss 3-5 days of school. It was even considered to send her home that day, but we decided an overnight stay would be best as she was comfortable and resting. My dad was called to bring more underwear and clean clothes, as she’d soiled hers from diarrhea; I met him in the lobby and he asked if we were sure we had her at the best hospital as he thought the Billings Clinic was better. I assured him that we were friends with several of the doctors at St. V’s, and that it was a great place to be. I wondered later if we had made the right choice; one in a long list of “what ifs”.
I went home quickly at 6:30 pm to shower and grab some things in preparation of spending the night with Fiona. It felt good to take off my “Life is Good” baseball cap and wash my hair. I would never wear that cap again and in fact threw it away out of a deep sense of shame. I showered quickly and rushed back to the hospital. Fiona and Ryan were resting and all seemed peaceful. Ryan went home around 7:15 pm to relieve my mom and be with the kids for the night. Fiona wouldn’t let him kiss her goodbye on the forehead as her head still hurt. She continued to have diarrhea but the nurses didn’t seem concerned as it’s one of the symptoms of flu. I helped her clean up and helped her to the toilet several times. The monitor kept beeping but the nurses said it was due to poor reading/attachment to her finger. New tape was put on but machines continued to beep off and on. I turned the lights down so Fiona could sleep but the beeping was annoying; how I wonder now if I’d contributed to her death by not throwing more of a fuss. Another “what if”. The last time I took her to the bathroom, she seemed a little off balance. I assumed it was due to being sleepy and sick.
At 8:15 pm the nurse came to do rounds and noticed the rash had gotten worse. She called the doctor, who was there at 8:30 pm and looked shocked; she said the word petechiae, an unfamiliar word to me. Fiona was taken quickly to the ICU. I packed up all our things and took them with us to the ICU; I assumed we were just switching rooms and I didn’t want to leave our things behind. Maybe I was in denial, who knows why we do the things we do under duress. Soon another pediatrician arrived to assist, and soon after that at least a dozen people were frantically working to save her life. Many procedures occurred next that I won’t relate in detail to spare the reader the trauma we endured. I tried to remain calm for Fiona’s sake, praying fervently for this spiraling, shocking decline to end. A chaplain was called to pray for her; he prayed she’d be able to return home, to play and continue her life. A nurse offered to call Ryan; I had to stop and try to think what his cell number was; I was completely terrified and immobilized in fear. He heard his phone vibrate thankfully, as he was in bed asleep. He arrived around 10:30 pm, shocked speechless by the sight of her condition. By 11:20 pm she was in full cardiac arrest; the next 45 minutes consisted of CPR life-saving efforts, but she was long gone.
Meningitis and sepsis were the first causes considered; the state ordered an autopsy as the cause of death was unknown. Her body was not viewable after the autopsy so we chose to have her body cremated. Her ashes are in a white porcelain urn with pink roses; we keep the urn in the closet. Due to the public threat of a contagious illness, Fiona’s death was in the headlines, making the loss of our daughter a public affair for all to comment, for people to see on the nightly news, to be a source of entertainment for lookey-loos; and for several women to accuse me of failing to get her vaccinated.
Fiona died of DIC caused by the flu virus which had damaged her lungs to the point of no return; her immune system overreacted to the virus and caused damage at the cellular level that we are told was irreversible and incurable. DIC is basically internal bleeding as the body loses it’s ability to clot and generate platelets. The rash I noticed at 4 was the beginning of DIC, but no one suspected it. I wonder if they had known, how things would have turned out. Fiona died a horrible death, but she was quite unaware she was dying; her awareness of things appeared to slowly fade away, and was allowed to do so because no one knew what was going on until it was too late to try any interventions, to call family to say final goodbyes, to witness her parents and family screaming for someone to do something. She did not cry nor did she see us “freak out”; instead she reached her arms up and smiled, and said she saw a light. Fiona was gone soon after that, although it would be a little while longer before her body stopped working. I wonder if she stopped to watch us all, puzzled by the ruckus, or if she flew away quickly, drawn by the beauty she saw.
Death is ugly, it’s foreign, demonic, not natural, especially the death of an innocent child, so full of life. Lamentations 3:33 says “For he (God) does not willingly bring affliction or grief to anyone.” We will never learn to live at peace with the death of our loved ones, content that it was “God’s will”; the hole Fiona leaves behind will never be filled and will remain empty until I see her again. In Lament for a Son, Wolterstorff writes “When the writer of Revelation spoke of the coming of the day of shalom (peace), he did not say that on that day we would live at peace with death. He said that “on that day there will be no more death or mourning or crying or pain, for the old order of things has passed away.”” For now, some of us must endure mourning, pain, crying and death. For now, the last day of her life is constantly in my mind. I hope someday to not be haunted by those painful memories that wake me up at 4 am. When Ryan thinks of Fiona, he dwells on thoughts of her enjoying being with Jesus, seeing Heaven in all its beauty and joy, and meeting her unborn siblings and other family. I hope to get there too, but the trauma of her sudden death has me stuck where I am for now.