Nothing is more delicious to the eyes of a five year old girl then the shimmering, metallic glare of a Zippo lighter. So when her Mom ran over to the neighbors to borrow some sugar, she climbed up the rickety kitchen cabinets and stood on her tip toes in order to reach the top shelf and pilfer the object of her desire.

After tripping clumsily back down, she sprinted to the table and crawled into her private sanctuary sealed from the world by the tablecloth. She rolled the metal cog with her thumb and watched the spark evolve into a mesmerizing glow of blue then yellow light.

Her baby brother started to stir and she craned her neck to listen for the cries she expected to come from his bedroom. As she turned her attention back to the gleaming object, she gasped in horror. The flames had jumped out of her hand and spread to the white cloth hanging down from the table. She sat transfixed for a moment until the woody smell wafted into her nostrils.

Quickly, she backed out and ran towards her brother’s room. She pushed a stool to his crib and climbed up. It took all her strength to bend over the railing and scoop up the crying infant.

By the time she exited his room and ran towards the door, she found her passage blocked by malevolent wisps and fiery tendrils. She turned abruptly and scurried into her mother’s room. She swiped the rosary beads off the dresser and crawled into the closet with her screaming brother snuggled tightly under her chest.

The last thing she recollects is arms of smoke rising from the crack in the door and forming a choke hold around her neck. She’s not sure when her brother stopped screaming or when the fireman broke down the door.

She doesn’t remember the funeral a few days later.

***

Angela was tolerating the back pain. She had done the MRI and could put a name on the lances of fire that shot down her thighs and into her calfs. But the shortness of breath was becoming debilitating. Her daily trek on the elliptical was exhausting and sleeping flat in bed was nearly impossible. The sensation came out of the blue and gripped her from inside out.

Her blood tests, chest x-ray, and electrocardiogram were normal. I probed into her life and could find no signs of anxiety or depression. I was on the cusp of considering a more aggressive work up when her symptoms disappeared. We decided to watch and wait carefully. We planned for a follow up the next week.

A day later her name popped back up on my schedule. As I walked into the room, I explained that it was either time for cardiac testing or that this could all be anxiety and depression. I suspected panic attacks.

When the words left my mouth, Angela shook her head in agreement. When she woke up the night before gasping and holding her throat, she had an epiphany. Her symptoms started shortly after getting the MRI a few weeks ago.

The enclosure in the metal tube must have brought back deeply buried memories of being trapped in the closet the day her brother suffocated. With this realization, her lost childhood returned. She could now recall the funeral and her brother’s angelic face. How many times throughout childhood had she awoken form a deep sleep with her heart racing and gasping for air?

She was sobbing now.

I have never faced these issues.

***

There is much monotony to being a physician. I have seen more variations of the common cold than I ever thought possible during medical school. But the foibles of the human body are often surprising.

You never know what you are going to face when you open that exam room door. Sometimes it’s chest pain. Others it’s a runny nose.

And occasionally it’s a middle aged woman trapped in the closet with a dead baby in one hand and rosary beads in the other. Decades later she is still mourning …

… and begging for self forgiveness.

Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion.

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