Five days later, Allison and Joe rose at dawn to get Nadia to the hospital early. She had an appointment with Rand.
The couple had learned long ago that it was best to avoid the morning commuter traffic into the city. And by getting there early, Nadia could have her blood drawn and the lab results would be ready when they saw Rand and Kate Anderer, the nurse practitioner who coordinated liver transplants at CHOP.
It was Rand's first day back. She was excited to be seeing her patients, to return to her regular Monday morning office hours, to something approaching normalcy.
Her schedule was a little disjointed because of her treatments. She still faced 28 sessions of radiation therapy.
The Kadis were thrilled Rand was back. They had been worried about her. And, feeling a little selfish, they wanted their doctor to be well, to help their daughter get well.
Joe was scheduled to go back to work the next day for the first time in months. He was praying for a quick in-and-out checkup.
Maybe, he hoped, Nadia had made enough progress to start cutting back on some of the many medicines he administered each day.
Sitting next to him in the waiting room, Allison was quiet. She hadn't mentioned it to her husband, but she didn't think Nadia would be going home today.
Over the weekend the Kadis noticed that Nadia's mouth turned a little blue when she slept. Her breathing seemed labored.
Once inside the examining room, Joe pulled out a small package containing 10 syringes - the medical cocktail that was keeping Nadia from rejecting her liver.
The first he squirted directly into Nadia's mouth. While Allison distracted the toddler, Joe flushed the feeding tube with water and started giving her the rest of her meds through the tube.
Sitting on the examining table, Nadia did not complain.
After a short wait, Rand and Anderer appeared. Both noticed Nadia's color was off, but they didn't say anything. Not yet.
Rand's curly blond hair was just starting to grow back.
The doctor and nurse practitioner were a practiced team. Anderer played with Nadia, gently examining her while Rand talked with Allison and Joe.
The first few days at home Nadia did well, Allison told the doctor, but over the weekend things got tougher. Nadia wouldn't drink much formula, and she seemed jealous of her baby brother.
Nadia weighed a little more than 17 pounds and was gaining nicely, the doctor said. It was time to discontinue the overnight feedings that she got through the tube.
Anderer and Rand switched positions. The doctor began her examination.
Allison asked about Nadia's breathing.
She had been fussy in the car seat on the way down. She seemed uncomfortable. And her skin took on a bluish tone when she cried.
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