Morphine snaked slowly, silently down the tube and into the boy's vein. His dark eyes were round and open wide, too big for his wasting body. The light was low. Fear filled the room.
"I hurt all the time now, Dottie," he said.The nurse tightened her grip on the boy's hand, almost imperceptibly. She didn't speak for a while.
"Do you get scared?"
She asked it serenely, quietly, matter-of-factly.
The boy nodded slightly, a little ashamed.
"A lot of kids get scared," she said. "It's a really scary time."
There was more silence. She kneaded his hand for a long time.
"I'm gonna go now," she said, finally.
"I have to see some other kids."
"I'll come back."
"After lunch. Is that OK?"
She didn't go just yet, waiting until he was more ready.
"Don't you want to see my ear?" he asked, stalling. "The scab fell off."
The nurse lifted the gauze.
"Oh, that's great. It's looking much better."
The boy looked pleased. He was ready now. As ready as he could be. She left.
In the hallway outside, Dorothy Ward-Wimmer explained that the 6-year-old boy "won't get to leave the hospital unless he gets to go to an extended care facility."
What she means is that he will die. Perhaps not soon, but too soon. He will not go home again.
The medical team making the rounds of AIDS patients on this day at Children's Hospital had conferred for 10 minutes outside the boy's room about how to help the youngster cope with pain. That's all they were left with.
There was talk of finding another place for him, a hospice.
Maria Simmons, the boy's primary care nurse in the floor's intensive care unit, is having difficulty with the prospect. Her eyes moisten. There is discomfort in the air.
"I'm sorry we have to take your patients away after they become your friends," Dr. Shelby Joseph tells the young woman.
The boy's mother, sick with AIDS herself and pregnant again, lies sleeping on a cot in her son's room. She does not wake when the doctors and nurses come in.
Later, Ward-Wimmer is asked whether the young boy is afraid of dying.
"No, he's afraid of being left alone in the room," she said.
When she is with one of her young patients, Ward-Wimmer is very still. Otherwise, she's usually in motion and something of a spectacle. A New York Giants football doll dangles from a chain clipped to her smock. There's a fat blue heart the size of a dime on one lapel and a button that says "I care for children and families." Underneath she wears a blue T-shirt, one of six from her hug motif collection. On this day the message is "I Give Great Hugs." Her short gray hair touches a yellow bandanna around her neck.
Everyone in the hospital seems to know her, and she seems to know everyone in the hospital. They all call her Dottie.
Over her desk in a cramped and cluttered office she shares with Joseph are rows of photos of children she has cared for, including her own three, now grown.
And there's this sign, a gift from a friend: "One Day I Shall Burst My Bud Of Calm And Blossom Into Hysteria."
Before coming to Washington, Ward-Wimmer ran a hospice in Neptune, N.J. She recalls the 4-year-old cancer victim there who taught her about dealing with dying children.
"I told him, `It'll be all right.' `No, it won't, Dottie,' he said.
"That is how you learn. From children."
But experience and learning don't make it any easier to accept a child's death, she said.
"We cry," she said. "The doctors and the nurses and the moms. We cry real tears. It hurts."
Upstairs, Ward-Wimmer has taped the dying boy's kindergarten report card to the door to his room, along with some of his art work - brightly colored cards to his mother and to the woman he calls Dottie.
"Although many skills and activities have been difficult for Michael, he has attempted everything with enthusiasm," the boy's teacher has written.
The next entry is "Days absent, 132. Days present, 49."
And finally: "Your child has been assigned to grade 1 for the coming year."