My first day on call, we had an admission come in that made my heart sink. A C-section gone horribly wrong resulted in the baby being without oxygen for several minutes, depriving his brain and other organs of life. He arrived to us unresponsive, intubated, bleeding from everywhere. His kidneys were in failure, and all the retained water made him so swollen you couldn't open his eyes. His parents sat in agony at his bedside, fearing the worst and hoping for the best. An EEG and MRI suggested significant brain damage, but it was impossible to predict what he would do. How do you balance telling parents the grim truth without shattering every hope of recovery? Wondering whether he would ever be able to breathe on his own and what was best for her son, his mom whispered to him through tears, "You have to show me what to do, buddy." Within the next 24 hours, he began making purposeful movements, regained his gag reflex, and started to work to breathe over the ventilator. A few days later, he was off the vent and learning how to eat. His kidneys healed and the swelling subsided, revealing a very cute baby. He will still struggle, and will almost certainly have significant developmental delays. Even learning to sit will be a challenge, but at least he will struggle while surrounded by parents, grandparents, and a big sister who love him so much.
I saw other babies who didn't make it. It's never fun to work a weekend that makes the staff say, "Normally we don't have that many die at the same time." But stories like the one above made weekends like that a little less painful. Nonetheless, I'm glad to be done for a while with the NICU, and move on the slightly bigger, slightly healthier kids.
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