After being admitted for an asthma exacerbation, our two and a half year old patient was doing better and ready to go home so we decided to round on her first.

Her room was dark, and our big team filed in. Attendings, residents, nurses, medical students. Someone flipped on the light and I squinted, confused, wondering why she wasn’t in her crib.

Her crib had been stripped down, and urine-drenched sheets flung about on the floor. Her young mom was curled up on a fold-out couch with three blankets which she pulled up over her ears to try and block out the noise. Our noise. Her daughter’s doctors.

And over in the corner, exposed and shivering in a rocking chair, was our wet little patient. Just sitting there, waiting for her mom to wake up and finish taking care of her. Or, at least just waiting for something to happen next. She blinked and stared straight ahead.

Her nurse, appalled, went to get more sheets and a clean gown. The medical students were embarrassed. My Attending was upset and began to try and wake up the mother, even as she shooed him away.

I picked up a blanket and wrapped it around the little girl. She scurried up on to my chest and locked her wiry arms around my neck.

And for the longest time, we all just stood there, enveloped in her neglect. And the realization that this was something we could not fix.
Dr D/6yearmed

This started as a post about leadership. About stepping up to the plate. Being A Role Model When You Don't Feel Like It 101. Donald Miller had a post a few months ago about leadership classes and church and what is a true leader anyway.

Because the truth is, we are all leaders in our own worlds. We know what we believe and who we believe. We pay bills, get kids to school, make sure there is dinner on the table every night. We have to decide many, many times a day - if we can afford something whether emotional, financial or other. If we get it right more than once in a while, leadership is a done deal. You a leader whether you want to be or not. Those around you are watching and learning. they are picking your brain just by standing next to you. One day, they may want you to listen and the next, answers. You are expected to be ready for either and the deal is, you are completely compared, if you want to.

So I have all these grandiose ideas about the essence of leadership and then I read Dr D post. It took the wind out of my literary sails. At first, I was furious with the mother. I couldn't get past her. A while later, the whole leadership thing came back and only then, could I see how it all tied together.

Is it about genetics or environment? Are some born leaders and others have to take classes? If I was defending leadership in court, I would argue that we are all capable but lack, want and the lack of want, maybe something we can't fix...