Dear Sister Deepa

Thank you for calling last night.  I know that you are very distressed with
the news and I hope that what I am going to write will somehow alleviate
some of the pain that all of us feel.   I feel that this is the best I can
do because I am not capable of telling you all the details without needing
suction, nasally and orally, or Lasix to get rid of my puffy face.    At
times, I do really look like Vincent when he had too much steroids!

Sometime before Vincent left for UH (University Hospital, PJ), I knew that
you were greatly worried because you heard my conversation with Dr. Cheang
about him going downhill.  I also sensed that there was one day when you
were so reluctant to leave him after your shift.  I managed to find out from
S/N Gan that my intuition was right.   So, I really understand how much you
care for him.  Vincent is very lucky and blessed for that.

The trip to UH was a blessing itself.  I do not know if S/N Sarala relates
to you how the decision was made - just like that.   Vincent was not
adapting to the BearCub or HoekLoos ventilators.  Dr. Cheang went out to
make a call and came back to Vincent's room and told me that we are going to
UH.  As usual, whatever he says, I say OK.  S/N Sarala was so amazed with
the way I handle the news.  And the next morning was exactly what you went
through.   Don't you agree that the whole thing was so smoothly done?

I could sense that you were a bit disturbed about leaving your precious
patient in a foreign place.  Initially, I was a bit worried too but I want
you to know that Vincent was very well taken care off there.   That lady
doctor whom you met fell in love with Vincent in a matter of days!  I do not
know how that lil fella captured so many hearts in UH in such a short time!
Let me relate to you his stay there.

He was hooked on to the ServoMaster 300 ventilator with a mean of 25 which I
know is a lot of pressure.  However, he managed to tolerate FiO2 of only
48%.  He only had one bad bronchospasm.  He was not paralyzed and only given
Dormicum as low as 0.5 ml.   All the time, he was able to move his limbs
which are something very encouraging.  At UH, he was taken care of by very
nice nurses and doctors are around 24 hours.  Most of the things that LWE
nurses do are done by qualified doctors serving their compulsory service.
Vincent was seen by Professors in Paed. Lung Specialist, Respiratory
Medicine, ICU care and Neurologist.   Most of these professors were Dr.
Cheang's 'teachers' once.  They are all as nice as Dr. Cheang.  (Good
teachers breed good student, I guess)

I am really glad that Dr. Cheang gave Vincent the chance of getting the best
treatment option in UH.  I am now very satisfied that everything has been
done for him.  I am feeling at peace with myself.  I do not know whether you
are aware that I was very, very adamant that only best be given to my
precious baby.  I have never hesitated to confront anything or anyone should
I feel that there is a little bit more that can be done for Vincent.

Once Dr. Cheang told me that Vincent may have Bronchiolitis Obliterans and
usually the treatment is heart-lung transplant.  This never waver me even
though I know that this sounds like an impossible thing to do.  I am
determined enough to take on the challenge of pleading for a donor.  That is
why I asked for Vincent's organs to be donated after his demise but
unfortunately they are not mature enough.  When Dr. Cheang told me that
Vincent may be epileptic and afflicted with mild cerebral palsy, I was never
down.  I went on to ask Anne (the physio therapist) on the available
preventive treatment in our country.  By the way, do let Anne read this
letter and to tell her that I have acquired a copy of NIV Study Bible and am
now reading up to Genesis.  I thought that Vincent would still be by my side
after I complete reading the six inches thick book.  However, I guessed God
has answered my prayers of:
1. Keep Vincent comfortable;
2. Make Vincent well enough to come home (my home, that is)
3. Be there for Vincent when I was not there.

Please tell everyone that Vincent passed on in his sleep.  I was there the
whole day and he had been opening his eyes all the time.  I was supposed to
leave him in UH and go back to Penang at 4.00 p.m. on 1st May.  However,
some things made me stay back in UH, without adequate spare clothings and no
decent place to sleep.  On the morning of 1/5, there were two dying babies.
The situation in PICU was very, very sad.  One boy who is six years old is
dying of sepsis and another baby the same age as Vincent is dying of liver
failure.  The boy's parent is Buddhist and the whole PICU was filled with
chants and the father kept saying 'bye-bye' telling his son to follow the
Lord Buddha.  The mother was not allowed to go near her son because the
relatives there said that her son can't go in peace if she cries.  How can
he go when they are keeping him alive with the medication to make his heart
keep pumping?  You know how much I know about Code Blue and I am really
frustrated on the boy's mother behalf.  The poor boy's life was dragged on
till the medication in the Terumo syringe complete at around 3.00 p.m.
Imagine going thru the trauma from morning till then!  The other Muslim baby
died very fast.  I was there to console the mother and at that time, it
never, never occurs to me that I am the one needing consoling later.

Vincent's father left at 4.00 p.m. for Penang leaving me with Vincent.   I
occupy my time looking at him and reading the King James Version of Bible,
which is very hard to understand.  Around 5.00 p.m., I got Nature's call and
went to the toilet.  Then I took a bath and went back to see Vincent.  I
left him for about less than 15 minutes.  When I was about to go in PICU, I
became very worried because the resus trolley and many nurses and doctors
were around him.  I know that they were resuscitating him.  I went to sit
down quietly in the guest room (where we sat before) and pretend that it is
just another false alarm.  Some minutes went by and I decided to call my
husband to stop his journey and wait for my call.  Then one of the doctors
came to me and tells me the bad news that Vincent did not respond to resus.
I was totally numbed but I still can ask her many questions.  She went back
to attend to Vincent.  I was so lost and decided to call Dr. Cheang for
comfort.  At that time, Prof. Lucy (that lady doctor you met) came running
to Vincent.  I could only cling to my hand phone with Dr. Cheang at the
other end asking me to calm down and hold on to the wall for comfort.  When
someone is as distressed as I was, no one can do anything.  I knew that
because earlier on I wanted to comfort that boy's mother but I just cannot
approach her.  I finished my call with Dr. Cheang and spend some minutes
alone.  I could see that all the doctors and nurses legs (with curtain
drawn) were static.  I knew that the only thing they could do there was
watching the ECG monitor.  Dr. Cheang must have perfect timing because he
called me back just when Prof. Lucy came to me to tell me that it is over.
I passed the phone to Prof. Lucy and they talked.  I went to Vincent.  He
was naked and puffed up.  There were needles on both his thigh because his
cut-down line got blocked when they pumped in the medication to resus him.
Though I was crying earlier on, I found enough strength to go near him and
ask him "Why did you give up so easily?  I thought we are going to fight
through everything.  But if you think this the best for you, mummy is ready
to let you go in peace."  After that, Prof. Lucy passed Dr. Cheang's call to
me but I cannot remember what I wailed to him.  I told Prof. Lucy to
maintain Vincent till his father (whom I have asked to turn back) reaches
his bedside.  I even asked Prof. Lucy to find out whether I can give his
corneas away but the ENT told me that the recipient will have problem with
astigmatism because the cornea is too small.  Then, I called his brothers in
Penang and talk to them one by one.  I have rehearsed this whole scenario
many times in my mind for months because Dr. Cheang had prepared me many
times.  Therefore, I could say some very nice and touching things without
wailing.  My words must be very, very touching because all doctors and
nurses cried.

We told Prof. Lucy to pronounce the time at 8.00 p.m. after his father saw
him.  Do you know what is most touching?  Even though he was given 35 ml of
the heart medication and most times the ECG was 0, he was showing signs of
sucking (like he did usually, very greedily) when his father reached him.
His father was not aware of how serious the situation was when I asked him
to turn back.  He also thought that it was another one of the false alarm.
It took him about 2 hrs drive back to UH.

Since Vincent had chosen such a dignified way to go, I also found the
strength to be the dignified mummy.  I was not that emotional as I would
have expected.  The nurses cleaned my baby, dressed him and according to
hospital procedure, tied his arms and leg, stuffed his nostrils and mouth,
label and wrapped him up with a white cloth like a present.  Then I carried
him to the morgue and cleared some documents. Thereafter, I carried him all
the way back to Penang, which is 4 hours drive away.  I talked to him like
normal and even sing him lullabies!

We stayed with him at the funeral parlour through the night.  He was seated
comfortably in his baby seat.  I read Psalm 23 and 51 and the Lord's Prayer
to him most of the night.  (Hey, I am not that well versed yet, so I got to
read instead of from memory)  He had so many clothes that he never got a
chance to wear.  He got brand new baby cot that he slept for only two
nights. He had with him all the things he had in ICU in LWE.  His funeral on
2/5/02 was very simple because we Chinese cannot give small children an
elaborate one.  We filled his 'cute box' with all his worldly possession
including a big bottle of Bebelac LF and Polycose and two bottle of my
frozen breast milk.  The undertaker also put in sweets and biscuits, for him
to distribute to all the other children up there, I guess.   Dr. Cheang gave
him a soft toy too.  I guess S/N Gan will fill in the other details with you
because I don't recall much.  I only know that everyone, including the
undertaker (whom I knew and was always at your ICU to receive his 'cargo')
has tears in their eyes.

Vincent was cremated on 2/5/02. We scattered his ashes yesterday 3/5/02 at
sea.  It is really painful to see some one I loved so much reduced to only
fragments of bones and ashes.  His silicone teat and pacifier however did
not burnt and remain intact when we went to pick his ashes.   Because of his
young age, we Chinese cannot keep any memory of him lest he had trouble
re-born.  So, let us keep him in our heart instead.

Though Vincent was here for only a short time, I am really proud to be
selected to be his mother.  That little guy who at times can't make any
sound, not able to smile or do anything more, had touched so many hearts.
It is amazing what he had done too many of us.   He brought out compassion
in our hearts.  Total strangers are captured by him.  He was the healthiest
looking child in PICU in UH.  All the other mothers always commented how
cute he is.  Let us take comfort that he chooses to go in such dignified
manner and that the Lord is so kind to relieve him of all pain and
suffering.   As what Dr. Cheang told my other sons, Vincent is now among all
the cute little angels in Heaven.  He must be enjoying himself there.

Deepa, I hope what I had related to you ease some of the pain because I feel
better already after I penned this.  I am really touched with the loving
care that you and all the other nurses and staff in LWE had shown to
Vincent.  Only God can repay this kindness.

Love,
Lilian
 

(P/S :  Deepa, you may pass this letter to your colleagues in ICU and 2B,
Anne and also Dr. Cheang if he has time to read.  Please remember Vincent as
the Little Hero who came, who saw and who conquered our hearts (Vincent
means conqueror or victory).