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The Messenger

Outside the operating room, this nurse is there to help anxious families

Surgical liaisons bring stressed-out parents reports on their kids, plus snacks.

Kathy Delaney updates a parent on her child’s procedure.
Kathy Delaney updates a parent on her child’s procedure. Webb Chappel for the Boston Globe

Everything about the surgical waiting room at Boston Children’s Hospital can be read in the eyes of parents. They dart upward as soon as Kathy Delaney appears, following her every move, never blinking, as if by staring they could decode the electrical flickering of her thoughts. Some mothers try to hook her with a smile. They try to be polite. But their eyes give away what they’re really feeling: a mixture of hope and dread that the news she bears is about their child.

Technically, Delaney is a nurse, trained to take pulses, give shots, feel for swollen glands. In practice, she’s a translator and mediator, a sort of white-coated diplomat. She’s the official emissary from the masked world of the operating room, bringing updates of kids suspended in chemical sleep.

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Today’s quiet, only 60 operations scheduled for the hospital’s 26 tables. Delaney keeps tabs on all of them. “Still drilling?” she says into the phone, to a nurse on the inside. She dials another room, lips pursed.

It’s summer, the season of day surgeries. With no school, students are free to have their tonsils out and the fluid drained from their inner ears — procedures so quick they can seem banal to a surgeon. Not so for a parent. “Longest hour of my life,” one mutters, hunkering down by a vending machine.

> Related: For more on Boston Children’s 150th anniversary, click here.

There are more involved cases, too. There’s 2-year-old Emma De Santos, an incorrigible thief of neighborhood hydrangeas, who likes wearing a tutu on her head like a wig. She’s been in surgery since 7:30 this morning, for the removal of a growth behind her left eye. What threw her parents into a panic was the surgeon’s description of the potential risks: the operation might bruise the brain, tear its leathery casing, or allow the intrusion of infection.

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“It’s just a helpless feeling,” says Brian, her father, a truck driver, his body spring-coiled on a waiting room couch. “As parents, we’re her protectors . . . and then you deal with something like this.”

Delaney’s updates, every 90 minutes, might seem like the oldest, simplest kind of medical care — but they were the product of a gradual shift, an innovation that swept from hospital to hospital alongside midcentury advances in surgery that meant procedures ran longer. Children’s started its surgical liaison program in 1963, well before such positions became ubiquitous. Even as the role spread in the 1970s, more hands-on nurses viewed them with a combination of jealousy and disdain. “They were called ‘clipboard nurses,’ ” says Arlene Keeling, a nursing historian at the University of Virginia. “It looked like they were walking around with a lab coat on and not getting their hands dirty.”

The whole premise of the job was foreign at first. To pediatric staff, parents could be an afterthought — and sometimes a nuisance. Family members weren’t allowed into the recovery room where a child was emerging from anesthesia. “Kids would be crying and nurses would assume it was pain, so they’d medicate them,” says Sheila Curran Campbell, who has been a nurse at Boston Children’s for 35 years. “I used to say, ‘M is for the mummy they need, not morphine.’ ”

Even now, those inside the operating room occasionally ask the nurses to appease families with reassuring fictions. “The surgeon will say, ‘Oh, the child’s hemorrhaging, but don’t tell the parents,’ ” Delaney says. She always tells the parents.

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She remembers her father, a small-town funeral director, and the ease with which he spoke to newly bereaved families. She’d watch him drink coffee before he attended to the body, swapping stories with the siblings and children of the deceased. That was harder than it looked. The first time a child died on the table during her shift, sitting with the parents felt like torture. She wound up weeping with them, as if their loss were hers.

Now, a family appears in her office unbidden, eyes wide. Their son’s testicle didn’t descend properly at birth, and is now being manually coaxed down from the abdomen. “I just got off the phone, everything’s going well,” Delaney says. “They first did the cystoscopy, which is looking in the bladder . . . but right now, they’re bringing down the testicle. Does that all make sense?” The parents look uncertain, so Delaney tries again: “He’s doing absolutely fine.”

In the next 20 minutes, she will cross the waiting room again, updating families on a cleft lip repair, a liver resection, a collapsed esophagus, and a growth engulfing the delicate bones of a 4-year-old’s ear. When she gets to the De Santos family, she tells them the team is now scanning Emma’s brain. “You don’t know if they’ve removed the whole mass?” Emma’s grandfather asks.

“They do the MRI to check if there’s any little stuff that they couldn’t see,” Delaney says. “They may have to go in and do a little more.”

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He slumps back into his chair. He tries to distract himself with pretzels and his family with jokes. Later, with Emma in the ICU, they’ll hear the surgery went well. For now, the air around them buzzes with unspoken risk. Tumors might prove malignant. Blood vessels might get nicked. Organs might succumb to infection. Eyes implore Delaney, as if she personally has the power to bring kids home safe. But all she can do is bring candy to the stress eaters, coffee to the weary, and whatever news she has.