CAUSE I KNOW I DON'T BELONG HERE IN HEAVEN


In the NICU, we have a bonding technique we offer the mothers whenever the baby is able and the parent is willing. We draw up the privacy curtains and ask the mother to take her top off, including the bra, and place the baby all across her chest, and then we wrap them both with a sheet laid across the mother's shoulders, covering them all the way to the front. In there they can bask in each other's warmth... in a world all their own, mother and child. We call it skin to skin.

It is not all the time that we can do this. Not when the baby is in a ventilator, with breathing tubes coursing through her mouth because she was born not quite developed enough to breath on her own. Not when a tube is piercing through the baby's tummy to evacuate the fluid that has accumulated there because of some infection that left her unable to manage her fluids in utero. Not when she has a central line threaded through her umbilical vein through which she has sedative and vasopressor drips running and an arterial line through which her blood pressure is being monitored and from which blood samples are drawn every so often for lab tests. Not when at any given time, a transfusion may be going through another line, through another limb

Often, when a baby is in this state, all that a mother could do is to look at her child, if she can bear... or touch it, if she's brave enough.

We have one such baby in the unit, been there for the past 2 weeks. It's a 29-week gestation female, born with nonimmune hydrops fetalis, secondary to gestational CMV infection. The mother is a 20-year old Hispanic who can barely speak English. I must admire her for being so brave in the midst of all the bustle surrounding the care of her child, for being able to hold her own, for not letting her confusion get in the way of her child's treatment, and all of that for one so young.

The prognosis for hydrops fetalis is not very good. In fact, it often results in death of the infant shortly before or after delivery. The risk is even higher in premature babies. For our baby to have survived for two weeks is atypical. For her to have gone off the ventilator after two weeks, as sick as she was, is a miracle.

After several days of critical care, this week saw our baby with only one peripherally inserted central line in place, with all IV drips discontinued, and she has gone from the vent, to nasal CPAP, to nasal cannula for respiratory support. And although she still had ascites (fluid in the belly), it was no longer as bruised as when it first started and the worst of the fluid has been removed, and what remained was left for natural reabsorption by the body. She was getting one medicine, just one left from all those she started with. Evidently, everything was looking peaches for our baby and with every adhesive removed, with every tube and line pulled out, her parent's smile came wider, brighter, happier. Last Thursday, mother and child hugged each other, skin to skin, for the first time.

Life would have been perfect if recovery was an ever forward movement. Unfortunately, it is not. Last night, our baby went bad and she had some alarming respiratory distress going. When our shift ended this morning, her morning nurse was getting ready for intubation.

I had a chance to talk to the mom before I left. In not so many words, she told me, 'When I held my child that night, it was the first time, and that was the only time she became so real to me, the very first time I really felt I had a child. I've been looking at her for days but in my mind, I had no idea. I felt my baby, and I felt she wanted to be there, and I want her to be... in my arms. She will fight to be back. I will have her back.'

Faith, hope and love. And the greatest of these is love.