Can we help?

One of my favorite patients on our peds rotation is a 6 yo hispanic girl with PPA (a metabolic disorder) . She's in the hosptial more than out due to almost constant line infections with nasty bugs. We've tried to arrange it so that she could be at home while getting her Vancomycin but Mom doesn't think she could handle that; Mom has other kids at home and The Little One really does take a lot of daily tweaking.

So The Little One stays with us most days. We threw a big birthday party for her last month, the secretaries have learned spanish in order to talk to her and try to teach her words, and the nurses throw little dance parties with her behind the desk in the evenings to keep her entertained. She's of course developmentally close to a six month old but is happy and seems to be having a fairly good quality of life.

Mom just asked me today if I could help her with immigration. Turns out she and Dad are both illegal. Dad left four months ago to go back to Mexico to help with their famlies - their parents are both quite sick. He was supposed to come back three months ago...but hasn't shown up. We don't know the full story - Mom isn't disclosing everything but I suspect he's either been caught or just can't get back across after multiple tries. Now Mom wants to cross back to help him and her parents. She wanted to know if there was anything we could do to help her get back across.

The fairly simple answer is 'no' and I told her that. We discussed the risks - she planned to go at the start of one of The Little One's hospitalizations (usually 14-21 days) and get down and back in a week. Bu what if she couldn't make it back? What if she couldn't ever make it back? What if she got hurt or died? Who would take care of The Little One? And who would take care of her other kids?

I cannot imagine being in that situation. I would be desperate to find and help my husband and my parents but I could never leave my children behind. How awful to be put in that position. I hope she doesn't go but I suspect she might. Who will take care of The Little One?

Medicine is so much more than making sure the Vanc trough is in the right range.