Within minutes, the story changed yet again. A more senior doctor appeared to talk to the family.
Nadia wasn't going to die, the doctor said, not that day. But she was seriously ill with advanced liver disease. Still, she was at the best possible place for a child in her condition.
Like the sickest 15 percent of the children who come to CHOP's ER, she would be admitted.
Nadia was going to 8 South.
At 9:47 that night, more than 4 1/2 hours after getting to the ER, the Kadis arrived on the liver ward for the first time.
Their small room was quickly crowded. In addition to Nadia's parents and grandparents were a bedside nurse, the attending physician, a fellow, a resident, a medical student, and Noelle Bates, the nurse practitioner who helped coordinate the care of patients on the ward.
While Nadia's parents and grandparents focused on the doctors, trying to understand what was happening to their baby, Bates picked Nadia up to ease her breathing.
Nadia stopped crying and fell asleep in her arms. Bates, 30, wouldn't forget that moment - how Nadia, whose stomach was too distended to be held like a healthy baby, felt in her arms.
The baby girl, with her curly brown hair and big brown eyes, stole her heart, and would soon do the same to the other staffers on 8 South.
A problem missed
Elizabeth Rand, a senior liver specialist, often hears the unusual stories through the hospital grapevine. Residents and fellows want her to weigh in on the complicated cases.
That's how she heard about Nadia. Clearly, the child should have been referred to CHOP months earlier. The staff was sympathetic toward the young parents. They seemed like nice people who had tried to do the right thing. Rand, 44, knew most doctors never saw a case like hers. It was unusual.
Rand had trained at the University of Chicago and the Johns Hopkins School of Medicine. A native of New York, she had come to CHOP to do research, but the pull of real patients was a strong one. In 1998, she became a full-time clinician.
Nadia's story made her angry and frustrated.
But in the end, she just felt sorry for the parents, and sorrier still that the opportunity to treat the child sooner - when the likelihood of a good outcome was significantly better - had been lost.
She and the rest of Nadia's team of doctors suspected biliary atresia, a disorder that afflicts one in 10,000 children. The condition destroys the bile ducts, which causes liver damage. Without treatment Nadia would likely die by her second birthday and certainly by age 3.
Biliary atresia is typically diagnosed within a month or two of birth. Nadia got to CHOP very late.
Her liver already showed signs of cirrhosis.
Rand couldn't predict whether the delay would change Nadia's prognosis, but studies showed that the earlier it was found, the better the kids fared. Even then, half of all the kids with biliary atresia require liver transplants by their second birthdays.
It was hard to predict what would be involved in saving Nadia. Rand knew medicine was imprecise, that survival often boiled down to a person's luck as much as their biology.
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