The toddler's dry, cracked lips had taken on a blue tinge that Monday morning. In fact, Nadia Kadi's normally light-olive skin was a darker, bluish hue.
Her parents brought her to Children's Hospital of Philadelphia for a routine checkup. But when liver specialist Elizabeth Rand saw the little girl, she immediately knew there was a problem. Rand examined her, and then turned to Nadia's worn-out parents.
Nadia needed to be readmitted.
As Joe and Allison Kadi waited for a room on 8 South, the ward at CHOP where kids with severe liver disease are treated, Nadia fell asleep in her father's arms.
Her breathing grew ragged, and she turned an even more alarming shade of blue.
Holding his daughter in the hallway, Joe wished her doctors could see Nadia now as she struggled for air.
He looked up. His wife, Allison, was walking toward him with Dan Leung, a young doctor in advanced training, who she had bumped into in a nearby corridor. Allison had asked the doctor to come check on her daughter.
"I don't like that at all," Leung said. "I think she needs to go to the ER."
But the Kadis wanted her on 8 South. They knew everyone on the 24-bed ward from the months they had already spent there during Nadia's illness.
A nurse rushed over from the nursing station to help. She placed a palm on Nadia's forehead.
"Oh, she's hot, too," she said.
Leung considered his options. Nadia needed oxygen now.
A nurse found a portable oxygen tank and mask. Another grabbed an electronic thermometer from a nearby room. A third paged an IV team. Meanwhile, a second housekeeper was sent to speed the cleaning of Room 16 for Nadia and her parents.
Joe woke his daughter and held her protectively as Leung connected the oxygen and a nurse took her temperature. Nadia cried. Her mother stood three feet away, her head down, crying, too. She could not watch, nor could she turn away.
On the way up to the eighth floor, Allison had laughed ruefully at a sign proclaiming Nurses Week. The Kadis had been here for Nurses Week 2006.
Last year, Allison and Joe had been here with Nadia praying - as they were doing now - that the people at CHOP would save their little girl.
But last year, it wasn't a blue tinge that had landed them in the hospital.
Last year, Nadia had been yellow.
Rendezvous at the ER
First-time parents, Joe and Allison Kadi felt they had asked about the yellow tone of Nadia's skin and eyes a thousand times. The Doylestown couple were repeatedly reassured the baby was fine.
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