Light and Shadow

Newly-minted doctor-intern Rob McNeal cares for pediatric patients ranging from newborns to young adults. Some will live minutes, others decades—the outcome isn't always obvious. Rob's task is to push for more life in their days and, sometimes, to accept fewer days. Rob's emotional and professional journey is interwoven with the lives of his patients, their families, and the hospital staff. His growing responsibilities impose a heavy emotional toll as he struggles to complete his internship. "Light and Shadow" dives deep into the daily soul-wrenching challenges of tending to the severely ill, often terminal, patients. During Rob's time as an intern, he must emerge as a capable physician with an expanded conception of what a doctor can—and should—be.

Newly-minted doctor-intern Rob McNeal cares for pediatric patients ranging from newborns to young adults. Some will live minutes, others decades—the outcome isn't always obvious. Rob's task is to push for more life in their days and, sometimes, to accept fewer days. Rob's emotional and professional journey is interwoven with the lives of his patients, their families, and the hospital staff. His growing responsibilities impose a heavy emotional toll as he struggles to complete his internship. Nine-month-old Vergil is fed through a tube threaded into one of his veins—a procedure that keeps him alive but damages his liver, makes his skin greenish-yellow, and poses the constant risk of potentially deadly infection. Fourteen-year-old Clara has a disease in which damaged flesh becomes bone, meaning she cannot walk and can barely breathe. Ella's eighteenth birthday is coming up, but her body has rejected her new heart after a transplant. With each person he works with, Rob begins to understand it's not about the condition, but about the patient. Every day is a new struggle, which pushes him to expand his capacity to care. The only relief for Rob is the hospital's crisis debriefing counselor and head chaplain, who winds up helping him reflect on the lessons of his internship. "Light and Shadow" dives deep into the daily soul-wrenching challenges of tending to the severely ill, often terminal, patients. During Rob's time as an intern, he must emerge as a capable physician with an expanded conception of what a doctor can—and should—be.

Chris Feudtner is a pediatrician, clinical investigator, and ethicist at The Children's Hospital of Philadelphia and the University of Pennsylvania who focuses on improving the lives of children with complex chronic conditions and their families. Over the years, he has conducted a wide variety of research projects and been involved in developing clinical programs. He also takes care of complex pediatric patients, including providing palliative care, and provides clinical ethics consultations. Feudtner lives outside of Philadelphia with his wife (a family physician), three children (one now off at college), and an inveterate squirrel-chasing dog, Rita.