It means that if the worst, the unthinkable happens, and the heart stops, and there is no brain activity... that the medical staff is specifically ordered to NOT take any life-saving measures.
It is a designation often given to the terminally ill, when the decision has been made by the patient and/or the family to not utilize certain measures to maintain or restore life.
It is a term that you might expect to hear in ICU, or on a hospice ward. Certainly not during a routine checkup with one of your child's doctors. And yet, here was the pediatric cardiologist, cheerfully, happily telling me that Twinks was a DNR, and congratulating her.
The pediatric cardiologists offices are situated adjacent the finest hospital in The Greater Metro. This hospital dominates the top of one of many hills that the city is draped over, and looking out of the windows, the entire metropolis lies at your feet.
The offices are state-of-the-art, and relentlessly cheerful, as most pediatric specialty offices are. The enormous fishtank, the play area, the tv's that run Nick Jr and Disney channel shows non-stop, the nurses and support personnel who are decked out in cheerful Dora The Explorer or Hannah Montana scrubs... it's all there, and then some. Each exam room is perfectly outfitted with comfortable benches and chairs, and a well-padded examing table. The technicians and equipment come to the childs exam room, rather than moving children from room to room, and every procedure - no matter how routine, or how often the child has it performed - is always explained before and during. The children are considered to be "active care partners", not just patients.
It is the best pediatric cardiological care in the entire region.
>:<>:<>:<>:<>:<>:<>:<>:<>:<>:<>:<>:<And now her cardiologist is telling me that my daughter - who at nearly 15 years of age has fought (and won) more medical battles than most people will in an entire lifetime - is now DNR?
I don't think that Twinks actually knew - up until then - what DNR usually stands for. Blissfully unaware, she was tying her shoe, and chatting with the Resident about what songs she has loaded on her Zune.
I gasped. I looked up at the doctor, and I know that all of the color must have drained from my face. Why was he saying this? It seemed as though the visit - a routine checkup - had been fine. In fact, he had been nothing but positive.
Why, why would he say that?
For one terrible, awful moment, I mentally flipped through everything Twinks has gone through medically, trying to figure out how or why he thought she should be classified as DNR. Did he have the wrong chart? But he had been *smiling*. Was this some sort of a sick joke? No, it couldn't be. Maybe I misunderstood - did I miss some horrible diagnosis somewhere?
I shook my head, trying to get all the pieces to fit together.
Twinks turned toward me, her smile fading. The doctor was reaching out his hand, attempting to steady me. The resident was suddenly on my other side, easing me on to the bench that was just behind me.
"DNR? What? Why?!" was all I could manage to put into words. I could hear this huge buzzing building inside my head, and a distant part of my brain said "So, this is what it feels like just before you faint".
The doctor frowned, and I thought, "This is it - pay attention", and I braced myself for what he was going to say. I thought how I wished that TW was here with me. I wondered how I was going to cope with whatever this was. I began to pray...
And he began to laugh. And then he apologized. "I'm sorry! I'm so sorry! I forgot!". I felt the blackness creep a bit closer, and I realized that my hands were clenched in fists, and I was rigid with fear. "Don't worry!" he exclaimed, "Twinks is NOT a DNR like you think! Oh wow! What I meant was, she's a Do Not Reschedule!". And he laughed again. "It's OK! Really!", he reassured me.
I felt like the gears in my brain were jammed. I couldn't process this fast enough. Reschedule. Reschedule. Do Not Reschedule.
I get it. We don't have to come back.
"You mean?" I asked hopefully... Twinks, now fully up to speed, whooped with joy.
"I graduated!" she crowed. "I made it! Woo-hoo! I'm. Done. With. You!" And she danced a little bit, pointing at the doctor, and grinning ear-to-ear.
I looked at the doctor, who grinned back, and nodded. "That's right!" he said. "As long as you don't have any symptoms, I don't ever want to see your mug around here again!"
And with that, he hugged Twinks, and told her that he wished her a wonderful life, and told her to go home, and have fun. And don't worry about your heart anymore. Because you will be fine.
It's just one of many doctors. One tiny victory, in an endless sea of pain, and medications, and tests, and procedures and uncertainty.
But it's one.
And that's one more than we have ever had.
Twinks graduated from cardiology.
Do Not Reschedule.