Nicole Meier was in the hospital last April, the day she turned 10. She was sad about that, until her favorite nurse sneaked a puppy into her room for a birthday surprise.

Nicole has rhabdomyosarcoma and a life consisting of chemotherapy and radiation treatments rather than roller blading or "New Kids on the Block." When you're 10, and the name of your disease has almost as many letters as the alphabet, a favorite nurse becomes the ice cream of your hospital stay. A favorite nurse is family.Steve Lloyd was the kind of nurse who stole the caps Nicole wore to cover her bald head. He played catch with her in the hospital hallways.

"He always cheered me up and made me feel better. He held my hand when I had to get spinal taps," she says.

Nicole cried when she heard Lloyd, a nurse practitioner, was called up with the National Guard's 144th Evacuation Hospital. He called her the day he left town.

So far, she's written him three letters. And on Wednesday, when she went to Primary Children's Medical Center for blood tests, she stopped in the lobby to sign the "thinking of you" cards for Lloyd and other hospital staff members who are part of Operation Desert Shield.

The care packages seem symbolic of the bandages that bind Utah's medical community. Every facility is making do. Every staff member is compensating for the extra workload created since two units of reserve doctors, nurses and medical technicians became active military. The medical units are headed to assignments in Saudia Arabia and Germany.

The losses to the medical community read like a casualty list.

- Primary lost 25 employees and seven physicians to the military effort in the Middle East.

- LDS Hospital lost 32 staffers and eight physicians.

- Pioneer Valley Hospital lost 10, mostly nurses.

- University of Utah Medical Center lost 58.

- The Veterans Administration Hospital lost 33 employees in the call-up, prompting them to close some beds.

"Our RN coverage was already minimal," said Janina Chilton, director of public relations at the Utah State Hospital in Provo. "They've called up all the nurses, so all the hospitals are going to be recruiting like crazy. It's pretty scary."

"A lot of these people who are getting called up now are specialists," said John Taylor, spokesman for Intermountain Health Care, whose hospitals have lost 120 employees and 30 doctors. "You just don't go out and replace those specialists."

"It's more serious in the nursing department, no question about it," said John Dwan, spokesman for the U. Hospital, "mainly because we've had a chronic nursing shortage for years."

Medical coverage in Utah's rural communities, already sickened by nurse and doctor shortages, is weaker.

In Primary lobby, Nicole Meier is signing her name to construction paper cards. "Come home soon," she wrote on Steve Lloyd's. The cards, created by patients, are a mosaic of names and best wishes. They'll fit into care packages filled with everyday things: lemonade, Carmex lip balm, Christmas decorations, stationery, gum. And Lifesavers.

When she isn't in the hospital, Nicole lives in South Jordan with her mother, Linda, her father, Jon, and four brothers. She has a quiet voice and a striking smile. Today she is wearing a pink T-shirt, black pants and a black bandanna tied around her bald head. Instead of a belt, she wears a case about the size of a hip pack for a Walkman threaded around her waist. It holds her portable IV unit.

She misses Lloyd most when she's back in the hospital. "I think she's lost without Steve," says her mother.

In her last letter, Nicole included a picture of herself, signed "Nicole Meier Lloyd."

She tagged on that additional last name, she said, because she wanted Lloyd to be able to brag about his Utah daughter.


(Additional information)

Dear Steve,

How are you? I am doing OK. I hopes that man Saddam comes to his senses. I also hope there isn't a war and the soldiers come to their families. I especially want you to come home. I hear people say it isn't the same at the hospital without you and that they miss you. They're right about it not being the same, but I miss you the most. You treat me as if I were your own child and I like that. You always say when I'm mad at my mom to be mad at you instead. I hope you think of me always. Come home soon. I was in the hospital this last weekend and I missed your visits and your playing Backgammon with me.

Your friend with love,