Molicia Sue-Ann Ashley 2006-2009.

Molicia was born in St. Vincent when her mother, Alesha, was just 14. She struggled in her first days of life because she was born with a rare congenital heart defect that prevented oxygen filled blood to circulate properly throughout her tiny body. She somehow managed to survive in the hospital for three months, until she grew strong enough to go home. Through the efforts and advocacy of many people, Molicia was able to travel to Richmond to receive surgery that she needed to survive, but because her defect was so complex, doctors knew that she would need more than one surgery. Still, everyone rallied around this little shining life because they knew that she would make it. A nurse traveled with her in 2006 and she had open heart surgery here in Richmond through the organization that I work for, International Hospital for Children (IHC).

(IHC works to connect children in Latin America and the Caribbean with life saving treatments that are otherwise unavailable to them due to circumstances and geography. I have helped to coordinate the care of over 200 children here in Richmond over the last 7 years, there are thousands more that live improved lives because of the efforts and contributions that are mobilized through IHC.)

While Molicia was here in the summer of 2006 with a nurse as her guardian, they stayed at the Hospital Hospitality House (HHH). My colleague, Lauren and I became close with both of them and took as special liking to Molicia’s (then named Ashley - long story) lovable smile and gentle attitude. She was a bright baby, perhaps because of all that she had faced in her teeny life span. She went home to St. Vincent after just five weeks with us here and went on to grow and play and thrive. When I saw her a year later while I was working with a cardiac diagnostic mission, she was running and jumping and dancing! I told Alesha “wow she is so strong and vibrant! You would never know that she has a sick heart!” Alesha then told me that she did still feel overwhelmed by being a mom, she was 15. She asked me seriously if I wanted to take Molicia home with me. I said “I would love to, but I can’t adopt a baby right now. I know you will become an even stronger mom and take in all the joy of having Molicia with you!” She left the clinic after Molicia’s echocardiogram and I didn’t see them again until two years later, March 2009, working again on the same assignment in St. Vincent.

This time, Molicia had grown even more beautiful than the last and was so content, just emanating smiles and happiness. I dreaded to hear that her home conditions were worse and that her young mom was unable to provide her with the parenting that she needed. I was so WRONG! Alesha had also grown more beautiful and confident in her role as Molicia’s mom. She sat patiently waiting for much of the day with a very well behaved three year old little girl. I have seen first-hand what loose discipline and negative parenting can do to a child’s behavior in this setting and it was clear that Molicia was so well loved and cared for that she was happy to just be with her mom behave! Molicia had her echo and the doctor confirmed that she needed her second surgery within the next six months. I chatted with Alesha, snapped a few photos, and said goodbye saying that I would see them in a few months!

After much planning and scrounging up funds for travel on their end, they did come again to Richmond on June 1. I have been so overwhelmed with wedding planning, pre-celebrations, finishing up with my NP management certification and leadership training and just life in general, that I did not make the time to go see Alesha and Molicia. I knew that they were in good hands with her doctors and nurses as well as IHC staff and volunteers. She went in for surgery on Monday and everything went very well. Within a day she was extubated (breathing on her own) and talking to mommy about how she was hungry and that she was in pain, which was to be expected during recovery. But Tuesday night, it all went downhill. She started having trouble breathing and the nurses in the PICU responded in many ways. Her breathing became more and more labored and they couldn’t determine the cause. A friend of IHC’s and mine, Jimmy, who is a PICU nurse called my colleague, Emily, to tell her to bring mom from the HHH to the hospital. Within an hour, Molicia had coded and was not responding to any medication or chest compressions. She passed away. She died.

Emily called me through that process, but my phone was on silent. These last few weeks I have been so careless about that even though I am supposed to be on call 24/7for these types of emergencies. I saw my phone when I woke up to go running at 6:15 and I just knew. I was in shock. Molicia had NO indication that she was going to respond badly to any of her treatments. I didn’t even brush my teeth or hair and just sped down 95 thinking WHAT THE FUCK!? Why?! I tend to not cry over patient hardships, this is my job. But little Molicia was our shining star. We loved her and knew her better than most of the great kids that we work with. Also, she wasn’t sick! She was doing great the night before?! This can’t even be real. But it was. Her mom was sitting there handling everything OK. I think she has had to deal with so many hardships with Molicia that she just developed strong coping skills. This being the second time this year that I have worked with a deceased child in the MCV PICU I didn’t feel in business mode. I knew what to expect and just focused on my emotions.

I couldn’t accept what had happened. But Alesha’s strength and outlook enlightened me. She was talking to a very gentle and spiritual nurse about Molicia. The nurse was asking about the last surgery. Alesha said that Molicia was very sick when she was born but that she made it to her first surgery. Then she continued “she needed that surgery so that she could…” and I thought she was going to say “make it to her next surgery,” which was my professional coordinating mind taking over. But she didn’t say that. She said,

“she needed that surgery so that we could have more time together.”

And Alesha was right. I had been freaking out in my mind that I was so saddened by her death and so angry and worried that it had to happen right as I was starting to enter the euphoria phase of being about to get married in under two weeks. I had been thinking, why?! Will I forever have to associate my wedding with this sad death? Will such a tragedy overshadow my happiness, dampen my happy memories? But at that moment, watching Alesha stand over Molicias little body, I knew that this was not the case, Molicia was now our little angel. Her exuberant happiness and smile, now immortalized, will be with her mom in hard times and good ones, and will be the memory that I hold of her, even in her death.