Liver and rest

I had a patient in clinic last week. 15 years old boy with decompemsated liver failure post Kasai for biliary atresia. His anatomy is complex so the transplant team recommended cadaveric liver donor for him despite father and sister compatible for him. He's going to school, still very much a boy due to delayed puberty and was cheerful. 

I am always more wary of the cheerful kind. It's an overcompensation, a mask for all the struggle. Many people look past it and see cheerful people as strong and well. Yet the strong ones are the loneliest ones. I always wonder if they get the chance to be safe and rest.

There's nothing I can for him other than wait for a suitable liver to show up. Before I send them off home, I asked him if he's okay and understand what's going on. He gummy smiled at me. 

His mom said initially he didn't want the transplant but his siblings talk him into it. So they're just waiting for a liver. 

I looked at him and smiled. I told him slowly

"You're a very strong boy. You're dealing with all this, not even an adult can handle this as well as you seem to be. You're still smiling, still going to school, still playing football. I want you to keep doing that, because that's your role. To live your life, study well, have an ambition, be a useful person in whatever you do, just dont be a doctor."

At this point, they all chuckled. 

"And be good to your parents and family because they're supporting you emotionally.

My role here is to help you physically, if you're sick, when you're getting your transplant. That's my role. So don't worry about when that liver is going to show up. Let us worry about that. You just enjoy your life, okay?"

I was teary. The kid was teary. His mom was teary. 

Happiness is when you're safe enough to rest. I hope that kid can rest.