My daughter Sammi was four years old when she had her first endoscopy. Between that first one in June of 2010 and the most recent one in November of 2013, Sammi had more than a dozen endoscopies, each blending into the next, a routine and ritual that she has endured more times than she’s had annual physicals in her pediatrician’s office. She’s had more endoscopies than years on earth or last-days-of-school.

The day before an endoscopy, I always posted a request to my friends on social media to think positive thoughts and project smooth, pink esophageal walls, free from the eosinophils that represented disease. “Think pink” became one cousin’s regular response to my requests, and a local friend whose wardrobe tends toward black and grey regularly surprised me by wearing a pale pink top on endoscopy days, leaving me excusing myself to dry my tears in the bathroom.

Sometime in the afternoon that day-before, the hospital would call us to tell us when to arrive for the procedure. At a children’s hospital, the younger children’s procedures are always earlier in the day, since all children being put under general anesthesia have to fast for eight hours beforehand. As Sammi got older, the start-time for her endoscopies got later, a sign of how long she’d been going through this process.

Most often, we would have to be at the hospital early in the morning. Bleary-eyed but unexpectedly focused and efficient, my husband and I would pack everything we needed before waking Sammi and her sister Ronni. A friend would absorb Ronni into her home and morning routine long before school hours, and we’d drop her off on the way to the hospital. Often, Sammi’s grandmother would be waiting for us in the surgical waiting room, a new toy or fancy notepad in hand to distract Sammi as we filled in paperwork, collected a urine specimen cup for Sammi’s participation in a research study on eosinophilic esophagitis, and waited to be moved to a presurgical hospital room.

If Sammi was nervous during this time, she didn’t show it. By the fourth or fifth time, she had begun to remember the order of things, the friendly waiting-room concierge, and the forthcoming afternoon of movies on the couch at home when it was all done. She didn’t seem to dread it. Changing her into the gown and the awful paper underpants frustrated her, but we learned to do that at the last possible moment. Time alone with her grandmother, the TV in the room, and our steadfast cheeriness kept her from worrying.

None of that did a thing for me, on the inside, despite how collected I seemed on the outside.

According to a 2012 study by The Lancet, 34 people per million in the 1990s and 2000s died as a result of being administered general anesthesia. I assume that was 34 people per million surgeries. With every surgery, Sammi’s chance of dying rose ever-so-slightly, statistically-speaking. With every surgery, I became more and more concerned that this would be the one that killed her.

How many chances did she get?

How many chances did I get?

I walked her into the operating room every single time unsure of whether I would ever see her alive again, unsure of what the last words I would hear her say would be. That doesn’t mean that I thought she would die, but that I didn’t know for sure that she wouldn’t.

I sang her to sleep. I kissed her head. I told her I loved her, and I said goodbye.

Endoscopy days were hard. Really, really hard.

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