Dr. Jacqueline Vidosh returned home from her clinic one afternoon late last year and hustled into the bedroom of her youngest child, Noah. She began troubleshooting with his home health care nurse, trying to figure out why his oxygen levels were lower than normal. Had Noah caught the cold going around their house in San Antonio? Jacqueline, an obstetrician, peered at Noah’s vital signs on a monitor as she absently petted the family’s Doberman.
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Noah, who was 4, was asleep on his side, facing a wall, his dark hair visible above the covers. He was surrounded by stuffed animals, and gauze pads and a box of purple medical gloves sat at the foot of his large, criblike bed. Wires and blue tubing emerged to connect Noah to medical machines.
Jacqueline emptied a cup of saline solution into the chamber of a nebulizer and attached it to the ventilator that Noah uses to breathe. As he began inhaling the moist, vaporized air, Jacqueline wrapped a vest around him and flipped a switch that caused it to inflate and deflate rapidly, beating against Noah’s chest to loosen any mucus that might be blocking his airways. Jacqueline used a syringe to check for residual formula in Noah’s stomach through his gastrostomy, a surgical opening in his abdomen. She then used a machine to induce coughing and employed a suction device to clear out respiratory secretions through Noah’s tracheostomy, a surgical opening in his neck. The process took about 20 minutes. Noah’s oxygen levels improved.
Jacqueline held her son on her lap and then carried him to the living room, placing him upright onto a frame that supports his standing and helps prepare him for learning to walk. For now, Noah uses a wheelchair. He smiled as he played with a plastic caterpillar, seemingly oblivious to Jacqueline’s worries.
That evening, Noah’s two older siblings raced in through the front door with their grandmother, who had taken them for haircuts. Jacqueline, who is divorced and shares custody of the children with her ex-husband, wolfed down some pizza with her kids and turned on a movie.