In the Eyes of Babes

Amazing experiences are never in short supply when you are a nurse. Neither, for that matter, are terrible ones, sad ones and hectic ones....The amazing ones, though, are the best--the ones you must focus on in order to preserve your soul and sanity in this line of work. These positive experiences might be described as happy, profound, surreal or enlightening. Some completely floor you with epiphanic gravity.

About eight years ago, when I was maybe five or six months pregnant with my daughter, Colleen, I took care of a critically ill newborn in the NICU where I work. He was on maximum life support after inhaling meconium at birth. Meconium is the baby's first bowel movement, which is not supposed to happen inside the womb, but occasionally does anyways. It is a thick, black, tenacious substance that binds up inside the lungs of the newborn if inhaled during the birthing process, rendering the respiratory system completely useless.

During report from the previous shift's nurse, I was told that the doctors had recently informed the baby's parents that he had maybe a 10% of surviving. The amount of meconium he had inhaled was phenomenal, and he was not showing any signs of improvement. They also mentioned that if he did pull through, he'd likely have profound developmental delays and chronic health complications.

A couple hours into my shift, I was preparing to use a suction catheter to clear some mucous from the baby boy's mouth and nose. I found myself peering down at my small, heavily sedated patient, his little body grotesquely swollen and discolored. The ventilator whooshed softly nearby, delivering tiny breaths into his lungs as the ECMO machine circulated his blood via two thick tubes inserted into the large vessels of his neck.

Suddenly, his eyes opened and locked with mine. I was completely taken aback by the intensity of his gaze. He couldn't move his head or body, but his deep brown eyes were sharp with eagle-eyed alertness. He furrowed his brow a little as if considering his predicament. He glanced back and forth briefly, then closed his eyes and didn't open them again for the rest of the day.

The whole incident lasted but mere seconds, but at that moment when he locked eyes with me, I threw that "10% chance" right out the window.

To hell with that! I thought boldly. This baby is going to live!

Well, a few days after that, he finally was weaned off the ECMO machine. He'd been on it for nearly a month--way longer than most babies who were actually expected to survive. Most people thought that when he did come off it, it'd be because life support was being withdrawn due to worsening conditions and not being able to do anything else for him. A few days post-ECMO, he no longer needed the ventilator to breath for him. A week later, he was tolerating food and no longer needed intravenous fluids. Plans for discharge were well underway!

....Three years later, his parents brought him to the unit for a visit. He was running up and down the hallway like a little maniac! He was talking happily and greeting everyone with a friendly grin. He displayed no signs of developmental issues whatsoever, and had strong, healthy lungs full of laughter and stamina.

There have been times in my career when I've been unsure about a baby's prognosis and would receive no sign or surreal indication about whether or not the baby would live. There have also been times when I knew on an entirely practical level that a baby would die and there was no sense in being unrealistic and hoping for a miracle. Even sadder are the babies whom everyone believes will make it and yet they take a turn for the worst. The pain of walking up to a tiny casket surrounded by shocked, grieving parents and family members is excruciating.

In this little boy's situation, had he not told me otherwise, I probably would have lumped him into the "who knows?" category and hoped for the best. He proved to me that you don't always need a voice to be heard. Sometimes, it just takes a look.