Reflections on the Ride

There is a wisdom that children seem to have from birth – the importance of savoring the present.  They neither dwell in the past nor live for the future.  They are always in the moment.  Yet, simultaneously, they dream large and they hope perpetually.  Even terminally ill children maintain this awareness and hope is what gives them resilience. During a recent bike ride, I was reminded of how beautiful and simple a child’s world view can be.  The onus is for us, as adults, to preserve this hope for as many children as possible for as long as possible.
My team and I cycled through 100 miles of Amish country side last weekend.  Along the way, we were met by several Amish youth.  The children, dressed in starched pinafores and overalls, were examples of restrained excitement.  They didn’t run along road as we rode by. They didn’t call out to us.  Our encounter was entirely nonverbal. 1 deposit casino A group sitting four abreast in an oversized adirondack chair, simply waved.  A pair standing beside a lopsided card table balancing the weight of an old cooler, silently beckoned to us with a cardboard sign stating “free water” in a child’s crayoned script.  Two children working in the field, interrupted their chore to watch the colorful masses roll by.  On their youthful visage, an unspoken acknowledgement of a transient but shared moment, a serene and content smile.  Two cultures that will never intertwine, but for now, they enjoy.
That smile . . . I had seen it before on a child’s face…  A 6 year old girl with terminal cancer whose home I visited as a medical student during a palliative care rotation.  She had recently returned from a trip to Disney World, her Make-a-Wish destination.   As I listened to the hospice nurse talk to her parents about her persistent weight loss, her pain medications, and her impending doctor’s visits, I watched as that dying child spun in circles around the family room.  On her face, that content, serene smile.  She knows.  But for now, she enjoys.  I noticed a flash of gold dangling from the wrist of this slight whirling dervish.  A charm bracelet, a momento of her recent trip, much too large for her dainty wrist.   She had flexed her wrist to prevent the bracelet from falling off.  I remember subconsciously understanding how the bracelet will not fit her wrist for a couple years, then the acute realization that the bracelet will never properly fit.  That bracelet, a reminder of a fun filled trip, now a symbol of milestones never to be achieved.   I imagined her parents wrapping the bracelet in layers of tissue paper, placing it in its box and burying it under the few personal belongings of hers they chose to keep.   I imagined her parents resurrecting her memory by bringing out the bracelet, fingering the assorted charms on what would have been her sweet 16, her senior prom, her departure to college . . .
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Bracelets, bangles, my daughter loves them all.  In her little jewelry box an assortment of plastic and metal bangles my mother in law carefully transported from India.  Many of them do not fit, but every once in awhile, she takes out her makeshift jewelry box and tries them on.  “This one almost fits mama!” she hopefully states.  For now, she now she enjoys wearing them, with her wrist flexed.  She is healthy; she is growing. These bracelets will fit her one day.  Same age, different fates – how did we get so fortunate?
Happy children’s voices descend upon us as we approach the last 4 miles of the 100 mile ride.   “We believe in you,” they say.  Through a clearing in the row of trees lining the street we spy children standing on a balcony.  Watching us like the little Amish children but with a different energy.  The timbre of their voices resonating with delight.  Their excitement transferred into the kinetics of their bodies.   Their faces brightened by a smile, at the same time content and full of anticipation.
We. Believe. In. You.
How can I let these children down?
I finished my century ride; however, my real journey with my patients and with Team CMMD must go on.
Lalitha Trivikram, MD


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