DEAR PICU,

We haven't met for a long time. It has in fact been 9 long months. It might be a record, since Jacob needed you the first time.

The last time we met I left you with great sadness. I remember thinking that it was the last time I was walking down the hallway with the staring glass doors. I had been told by two of Jacob's doctors that they didn't think Jacob had much time left to live. They told us to prepare for Jacob to pass. Luckily, the doctors jumped the gun. Our boy is still here, and in the familiar fish bowl tonight.

It's with mixed feelings, I meet you again PICU. The nurses and doctors are as excellent as they have always been. In fact, I am catching myself wanting to help out with a diaper change or sliding Jacob's vest under his back, but no need for a tired mom to take care of those things in the PICU. There is always a nurse ready to do the care. I'm still watching every movement from my chair, ready to jump in or give a little piece of advice if I think it can benefit our boy. Habits are hard to change.

PICU, you haven't changed much. The bathroom smell is ingrained in my memory, and it came right back at me. The fridge is a sad sight. Food is an after thought in here. Coffee cups are not. They fill the trash can to its' maximum. The bed screams for an egg crate mattress I forgot at home. The alarms are never ending. The sickest of the sick kids are filling all beds tonight.

PICU, if it weren't for the people in here, I would give out a big scream. But it's hard to not feel the compassion and heart from Jacob's team. They are all amazed to see Jacob's name on the board tonight. They realize how long it has been, since Jacob took a visit down to the 3rd floor. One fellow who has scratched his head numerous time thinking about what is truly going on with our boy said that Jacob just had to come and see him before he's heading back home to North Carolina to practice medicine. Many docs have followed Jacob for years, and taught them that no text book was ever written with him in it.

PICU, please take excellent care of my boy. I'm a scarred mom from our last encounter. I never ever wanted to put my foot in here ever again. I still remember the pain and tears from looking at Jacob's brain MRI and doctors shaking their serious heads. I still remember as if it were yesterday having heavy decision making on my shoulders as dad and sister were in Sweden. I still remember the urge to leave and take my boy home, so I could think clearly, something I couldn't do in the fish bowl, aka PICU.

PICU, I know my son needs you tonight. His blood pressure dipped in the ER earlier today. That stuff scares the pent house, aka 9th floor. I hope we can take all the brain power of Jacob's medical team, and figure out what is causing our boy to have a very high heart rate since last night and a blood pressure too low. It could be his atelectasis they discovered a week ago or it could be a new infection brewing. The big guns antibiotics are on board tonight.

PICU, let's find some peace together this time. I don't need any new scars.

Love, Maria.