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The tree went up quietly last December in a small, fifth-floor conference room at All Children's Hospital.
There were no blinking lights or festive decorations like the countless ones already decked out for the holidays around town and beyond, no fanfare or laughter. But the spirit of giving and love still filled the room in a powerful way, amid the silence and the tears.
A handful of nurses from the Pediatric Intensive Care Unit (PICU) gathered in front of a beautifully crafted cut-out of a tree - a swirling, storybook design with leaves blossoming and roots extending toward a simple message at the base:
Organ Donation / from life to life
It was a simple reminder of a harsh reality that nurses of the PICU face on any given day: that some of the children whose lives they touch by pouring themselves into their round-the-clock care - children who touch their hearts in return - don't heal or ever get to return home.
Yet at the same time, there was something uplifting and hopeful about this four-foot-high artistic addition by the front door, giving comfort to the intensive care nurses as they gazed at it.
The tree would be a new way to honor those young patients who, while having reached the end of their own lives, had helped enhance or make possible life for others.
In a warm, understated way, it would celebrate the memory of a child who had passed - and a child with new chance at living - through the priceless gift of organ donation.
"For many of the nurses here, unfortunately part of their job is to go through this heartbreak of losing a patient," said PICU director Melissa Macogay, sitting at the conference-room table a day after the tree arrived. "For many, this makes it worth it somehow. It gives it a bigger picture. This is why we do this, because in turn, somebody else may save a life. Sometimes, that's the only good that comes out of some really horrific weeks."
The idea for the tree began with PICU nurse Traci Gregory, a member of All Children's Donation Advisory Council, who attended a LifeLink organ donation conference earlier in 2012. The conference utilized the symbol of a tree and the theme of butterflies to signify organ donation.
One of the PICU donor families from All Children's was in attendance and the father addressed the conference, explaining what a source of comfort it was to know his late daughter's heart lived on in another child. He went on to explain how she loved butterflies, and how every time he sees one, he thinks of her and feels buoyed by her memory. Traci and her entire table were in tears as they listened.
She returned to All Children's with a burning desire to introduce an organ donation symbol that would represent the lives lost but also sustained each year.
She envisioned a tree of life, with butterflies that could be attached to it - each one bearing the name of a child whose organs had been donated. At a crowded meeting of PICU nurses in their second-floor team room, Traci presented her idea excitedly - driven by her passion for the topic and spurred by something deep inside. Everyone instantly loved it.
"It was the middle of a shift and all these ideas just kept growing," she said.
The only question was how to represent the tree most effectively. A brainstorming session followed, with suggestions first for a picture, then a painting, and finally a three-dimensional representation of a tree that could be moved around if needed.
Melissa contacted Creative Services Director Mike Sexton, who conveyed his vision for the design to a company that produces graphic arts projects, and later formulated the words and type. The months-long project culminated with delivery of the tree of life inside the room used for exchanging patient reports, eating meals and taking short breaks from the constant pressure of the job.
Melissa and several other nurses were there to see it. They couldn't muster any words at first. Instead, they simply stared at the little tree: lost in their own thoughts of children they had fought and fought to keep alive - and then, of coming to the eventually painful point of preparing those children to give life to someone else.
As news of the tree's presence spread, more and more nurses stopped in the room to see it.
"Everyone who walked in, it would just bring them to tears," Melissa recalled. "People just looked at it - and felt its meaning."
But sometime around 6 p.m. that same day, the meaning of the tree grew unexpectedly more profound.
A young boy had lost his life. His organs had been donated to help other children. Only a few hours after arriving, the tree had a butterfly - with small white wings bearing the hand-written first name of the child whose life had ended but given flight to others.
"It's surreal how those things happen," Melissa said softly.
Other nurses felt the power of the tree as well, in their own ways.
"It's a good way to show that what we do doesn't end here, that life goes on," said Brittany Krehely.
A few feet away, Liz Halterman found meaning in the tree for fellow nurses as well as the children whose lives it celebrated.
"Everything we do, and all the emotions we go through, it's almost like tree makes us feel appreciated," she said.
Then there was Traci.
She wasn't at work that day to see the creation she helped bring about. When she arrived the next morning and stepped into the conference room, she noticed the tree - and then grasped the impact of the butterfly in a wave of emotion.
"My heart skipped a beat," she said. "It really hit home."
In fact, it hit home for a deeply personal reason - a part of what fueled her resolve to create the tree memorial in the first place.
Five years ago, Traci suffered a devastating loss with the death of her 11-year-old son, Hamil, from complications of cerebral palsy. He was born prematurely at 25 weeks and spent the first six months of his life in All Children's Neonatal Intensive Care Unit. Affectionately nicknamed Papi, he became an organ donor at All Children's, giving life and hope to other children.
"It meant so much to me to be able to donate," she said. "It gave me something when I had nothing, a little bit of hope for someone else, I guess. I still think about the kids who got his organs and how they may be doing now, how old they may be and when I get organ recipients in the unit I always think of him and the parents who donated on their children's behalf."
There's something else to know about Traci. She studied to become a nurse because of Hamil, initially hoping to join All Children's NICU and become part of the caring network he experienced at All Children's. But there were no openings when she earned her degree after his passing, and instead got a job in the PICU. "That's where I firmly believe I was meant to be," she said.
She went to work in the same unit where her son's organs were donated, giving comfort each day on the job - along with her fellow PICU nurses - to other sick or injured kids and their families.
Just as the tree of life is now a source of comfort to the caregivers.
"It so important for the nurses to know the impact they are making," Traci said, "and to know that the life we weren't able to save, maybe in the end it can save many others."
The staff is currently discussing ideas for how to visually represent the children who receive organs - perhaps on an attached scroll or with butterflies placed in a cloud above the tree.
Whatever the solution, the tree already has taken on its own life, quietly heartening the nurses of the PICU amid the heartbreak that comes with the territory.
"Nursing anywhere deals with loss and sadness, and difficulty and stress," Melissa said. "That is the life of the ICU, unfortunately. Half of our population is scheduled types of patients who will do well. They'll come in. They had a great surgery. They'll recover. They'll go home.
"The other half is just related to what happens in the community. And unfortunately, that's accidents. That's kids falling out of buildings. That's kids falling in pools. It's the nature of life. That's what we do here."
And why a simple little tree, far removed from the holiday-season glow, shines so bright.
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