Brianna never had a chance.  Trapped in the body of a prematurely aging woman, Brianna suffered from a breathtaking host of illnesses--recurrent seizures, recurrent infections, nephrolithiasis with kidney failure , asthma, and a rare immunological disorder of impaired neutrophil killing power.  Along with multiple University specialists, I followed her throughout childhood, and eventually I had actually  tabulated a list of 20 active diagnoses in her case--one for each year of her life. Her teeth were all pulled and she had dentures when most children had braces.   Her asthmatic condition was a pitifully small part of her problem, but I "did my duty as a good allergist" and kept her breathing parameters in the Green Zone with allergy and medication management.

But controlling her asthma and optimizing her Peak Flow did not optimize her life.  Far from it. Optimal breathing doesn't always guarantee an optimal life....Control of asthma doesn't always bring us to The Promised Land.   

Amazingly, Brianna wasn't prone to excessive complaining.  We developed a bond over the years, and she always seemed to look forward to seeing me. She got in the habit of sending me a Christmas Card each Holiday season.  She liked to play the flute, and one of my favorite cards from her shows her with the flute in her hands and her magnificent smile, which I wished I had seen more..  I enjoyed the cards, because I enjoyed seeing Brianna smile in them.  But I struggled seeing her with each visit--doctors always enjoy being able to offer patients meaningful help, and my own help in regulating her asthma seemed pitifully insignificant to me.  

But no matter what all the specialists and doctors did, Brianna remained sick.  One day, when I was seeing Brianna, she looked unusually despondent.  I let her talk--about her illness, and about many things.  Many things.  She suffered not only physical but profound emotional pain, for she had been hurt by other people, and as much as I could, I tried to take some of that pain onto myself as I listened.  She cried.  She cried for the body she never had, for the healthy childhood she never had, and mostly about feeling so hopeless.  She felt, in a word, trapped in her body. 

I knew that one thing that had sustained Brianna through her difficult life was her spiritual fortitude.  I had sensed this a number of times in our conversations,and as Brianna sat and cried on the exam table, I suddenly felt a strange urgent need to say something to her.  To validate something that I sensed she intuitively knew, but had never been told by another.  I stood close, and waited until our eyes locked...then I stated 

"You know, Brianna, someday you will have a perfect body."  

She said nothing, and initially looked downward, and then up towards me...

Then a magnificent smile crossed her face.  A stunning smile-- more  radiant and  brighter than any smile I had ever seen on her face before.  

Then, she whispered calmly and firmly,

"I know".  

At that moment her face and smile were burned into my memory, and I can still see her leaving  my office with that smile, and contentment... When her sister called later, and informed me of her death, she told me how much Brianna had enjoyed our relationship, and that Brianna had wanted me to know that.  I still keep Brianna's last Christmas picture on my office desk. And I often look at her, smiling, with her flute.   

And as I write this, it's Easter morning.  And I think of Brianna.    And I look forward to seeing her again.  

In a perfect body that she never had, but with her perfect smile that she always had.