Each year during our fund-raising campaign on behalf of Children's Hospital, we visit the emergency room on the Saturday night before Christmas. This year's visit took place on Dec. 22. My associate, Alexandra B. Stoddard, reports:

At 7:45 p.m. the staff of Children's Hospital's emergency room awaits the arrival of a two-year-old girl who has been in a car accident. She is reported to be unstable and is being transferred from a hospital in Cumberland, Md. A MedStar helicopter team had been assigned to transport her, but it has had to turn back because of heavy fog. So the girl is being brought by ambulance. It will be almost two hours before she arrives.

Meanwhile, D.C. Fire Department paramedics wheel in an 11-month-old girl who cracked her head open when she fell from a standing position onto a hardwood floor. She is restrained in a neck brace and strapped to a wooden board to decrease the risk of further neck or skull injury.

She screams as her mother, thin and pale, listens to a nurse. An older daughter holds the side of the stretcher and says loudly, "I'm not sick, and I don't want to stay." Matt Bourne, a nurse in the E.R., has seen such behavior before. He walks over to the little girl and puts his hands out. Smiling, she slaps them and then puts her arms around his neck.

The emergency room is shaped like the letter H. In the center is the main desk and the communications center, which allows the staff to contact transport teams in the air and on the ground by radio. Eight rooms along one hallway are designated for more serious cases, including a room that handles asthma and other respiratory cases. Behind the registration area is a screening clinic, where colds, coughs and low-grade fevers are treated.

At 9:20 p.m. Leslie O'Brien's beeper goes off. "One trauma stat, seven minutes," the voice says. Leslie, the trauma coordinator at Children's, explains that the two-year-old car accident victim is seven minutes away from the hospital.

Two minutes later, an ambulance pulls up outside. A nurse runs over to the double glass doors at the end of the hall and begins to open them. "That's some seven minutes," she says.

There is a delay of about three minutes before the patient is wheeled into one of two rooms specially designed for trauma cases. She is unconscious but both eyes are open. One eye socket is severely bruised and swollen. Eleven people from Children's, the Cumberland hospital and the Frostburg, Md., rescue squad assemble around the girl. Gently, they lift her onto a table.

The rescue squad personnel wheel the stretcher back outside as each member of the code team carries out his or her assigned role: taking blood, checking the I.V. and vital signs and reviewing the X-rays taken in Cumberland.

After a few minutes, the surgeon, Dr. Lisa Curcio, steps outside the room to take a phone call. She describes the accident as a "fender-bender" in which a mother was pulling her daughter from the back seat into the front when she lost control of her car. The girl was not wearing a seat belt. Her head apparently hit the windshield. Dr. Curcio says the girl did not lose consciousness at the scene, but "went down fast" once she was hospitalized in Cumberland.

X-rays indicate that the only broken bone is the left orbital, over the eye. Dr. Hezi Waisman, the attending physician, says the patient is stable and will be brought upstairs to the Intensive Care Unit. However, since she is intubated (breathing artifically through a tube inserted in her windpipe), she is still considered critically ill. Dr. Waisman says the next 48 hours will be crucial because of potential swelling or hemorrhaging in the brain.

During the evening, children stream in and out of the E.R. with various problems, some serious, some not. But each child is treated individually by the staff and given the same attention.

An 18-year-old Nigerian girl who has been in the U.S. for only four days is admitted for treatment of possible malaria. A boy with a broken arm has come all the way from Charles County because his father insisted that it be set at Children's. A mother says her 3-year-old girl complains of pain when she urinates. At midnight, the waiting room is still full.

The E.R. staff doesn't always know the outcome of the cases it treats. But the staff made it a point to ask about the 2-year-old from Cumberland, and the news was good. As of Monday afternoon, she was doing well and had been moved to a general care floor at Children's.

Leslie O'Brien says it is always sad to see children hurt and sick. But the reward of helping them is what makes the staff at Children's love their jobs.

"Once you see how they are treated, and how the staff responds to them," said Leslie, "at least you know they are getting the best care here."


Make a check or money order payable to Children's Hospital and mail it to Bob Levey, The Washington Post, Washington, D.C., 20071.