Dream magazine

When Fadi Marto was 3, he came down with what his parents thought was a routine stomach bug. But when he didn't improve in a few days, they visited a pediatrician in their native Jordan. After many tests, an MRI revealed a large tumor in Fadi's brain.

The doctors in Jordan offered little hope, so Fadi's parents turned to Michael Scott, MD, chief of Neurosurgery at Children's Hospital Boston.

On the flight to Boston, Fadi became paralyzed from the waist down and lost much of his sight, and a full assessment at Children's showed that Fadi's surgery couldn't wait. "The tumor was very large and was causing considerable pressure in Fadi's brain," says Scott. "We knew the operation needed to be done right away."

During the procedure, Scott found that the tumor had spread to Fadi's spinal cord, making complete removal impossible, so Fadi went through radiation to target the remaining tumor. "After radiation, he still had minimal movement," says his father, Souheil. "The doctors told us that at best he would be able to stand up, leaning against a chair or table for support."

But Fadi and his parents refused to accept that prognosis, and just one year after returning to Jordan, Fadi took his first step. By the following year, he could walk across the room, then in his neighborhood and beyond. "At first, he had splints on his legs, then he moved to a walker, and then to crutches, all of which he fought," recalls Souheil. "He was really determined to walk on his own."

But walking wasn't the only challenge Fadi faced. After all of his treatments, he had lost almost everything he learned in his first three years. "We had to completely start over, teaching him the colors, numbers, everything," says his mother, Abeer. "The doctors recommended that he learn more than one language, so in addition to Arabic, Fadi learned English."

The Martos returned to Children's in August 2004—eight years after the original diagnosis—so Fadi could have surgery to correct cataracts caused by the radiation. He's expected to retain his vision, and went home to Jordan in September, to the school where he keeps up with the other kids academically, and they try to keep up with his fighting spirit. "Fadi has become an inspiration to the kids at his school," says Abeer. "They say, ‘If Fadi can do it, I have to do it.' They call him ‘Fadi the fighter,' and that's truly what he is."

This is just a test

The defibrillator is real. So are the ventilator and vital-signs monitor. A code cart stands ready with medications. Real oxygen flows through the tubes and pumps. And the tension in the crowded room is teeth-grindingly real. In fact, the only thing that isn't real in the Simulator Suite is the patient.

The residents, fellows, critical care nurses, and respiratory therapist are responding to a mock Code Blue, where a boy-sized mannequin has an irregular heartbeat, faint but palpable pulse, dilated left pupil and a difficult-to-ventilate airway.

Three unseen video cameras record the resuscitation's progress. In a control room, Simulator Program Coordinator Liana Stanley, MEd, edits the scene on the fly, "voices" the boy and reprograms a computer to add new twists to his clinical condition. Later, the clinicians watch the videotape and discuss what went well and what didn't. Non-judgmental, constructive feedback is the rule.

"You watch yourself on the video taking forever to reach the right decision," says senior resident Jennifer Noon, MD. "It's kind of agonizing, but the next time you'll get to that decision faster."

Now in its third year, the fully-equipped Simulator Suite is one of the nation's first based at a pediatric hospital, and is used to train critical caregivers throughout Children's Hospital Boston. The lessons learned here are not soon forgotten.

"The material gets imprinted on the mind far more effectively than when we sit around the table with them saying, ëOkay, guys, don't forget to do this,'" says Jeff Burns, MD, MPH, co-director of the Simulator Program. "There's no question our emergency preparedness is better."