Wednesday, September 30, 2009

One Pound.

One pound, fourteen ounces.

The weight of the jumbo can of pumpkin I used last night to make muffins. The weight of my cosmetic bag. The weight of my running shoes, my coin purse, my water bottle.

The weight of baby Ella at 26 weeks young.

I donned a mask, grabbing the blue face shield before I walked through the locked door of the NICU. The neonatologist stood watch, clipboard in hand, next to a small plastic incubator. The incubator with tubes & tape & cotton & wires keeping this young, fragile life alive.

Her raw skin peeled already—just four hours after birth. Her chest rose & fell in sync with the sound of “whooshing” air, gentle positive pressure airways held her trachea open to allow adequate oxygen exchange. Like a covered birdcage, the yellow elephant blanket draped over the top of the incubator darkened the fluorescent lights above.

And we joined the watch.

She is doing well,” the neonatologist told us, “But the next 24 hours will determine everything.”

And “everything” wasn’t an exaggeration. Vitals scribbled on the clipboard, the plan of care carefully dictated.

Just two hours earlier, we’d make rounds with a perinatologist—a specialized Obstetrician whose training in advanced fetal care gave him knowledge to recognize, diagnose, & potentially treat fetal diseases. With years of specialized training & over 30 years of practice in high-risk obstetrics under his belt, he knew. He knew that babies born at less than 27 weeks have a significantly decreased IQ. He knew that babies born at less than 27 weeks have increased risk of chronic disease, increased chance of incompetent bowel, and decreased neuronal connections in the brain. He knew that babies this premature, this underdeveloped showed smoother brains & severe neurological deficits. That these babies had a risk seven times greater than a full-term infants for Cerebral Palsy & that their chance of social competence & marriage was less than 25%.

And he knew that he had to tell the parents.

So while we stood watch over this one pound baby now growing & developing outside the womb, this one pound baby with red peeling skin in a bed of cotton & tubes, he made his way to the ICU…the ICU where Mama lay in a medically-induced coma.

Young & vivacious, mom’s body was suddenly a mirror of little One Pound—limp & red in a bed of cotton, tubes, & wires.

She lost so much blood,” he said, “and the next 24 hours will determine everything.”

And “everything” wasn’t an exaggeration. Orders written for more platelets, more medication, more bed rest.

Her six year old waited outside, hand firmly in the grasp of wet-eyed husband. Her two-month hospital stay with complete bed rest for placenta percreta had come to an end—the end everyone whispered about & no one hoped for.

The surgery was emergent. Four specialists waited on the sidelines of the main O.R. Blood bank was on alert. The NICU was ready. LifeFlight was warned. And we lingered by the phones for the updates.

And so on this day, we wait. We ALL wait.

We wait for little One Pound to grow. To develop. To breathe on her own.

We wait for Mom to recover. To heal. To grasp the news of that this was her last baby because her uterus had to be removed to save her life.

We wait for the tubes, the wires, the cotton; we wait for the compassionate nurses, the wise physicians.

We wait for the grim news. We wait for the miracle.

Sometimes I think we wait too much—for life, for death, for lab results, for transport. We wait for the bad news…& sometimes the good. We wait for the right time to deliver the diagnosis, to counsel the patient, to give the medication. And in the midst of that waiting, I too often forget to recognize the sensational people I’m surrounded by: Little One Pound. Brave Mama. Skilled physician. Well-versed nurse. I too often forget to notice the miracle of the present moment: A 26-week-fetus—ALIVE. A severely compromised Mama—SAVED. An incredibly skilled physician—MY TEACHER. Those amazing compassionate nurses—MY MENTORS.

The First & Final Physician—MY SAVIOR.

I think they look good,” I say, “and the next 24 hours will determine everything.”

And “everything” isn’t an exaggeration. A whispered prayer makes its way heavenward & The Physician whiddles the "everything" into a miracle.


Brianna said...

Seriously you have a gift with your words... I love, love reading what you experience in your writing. It is beautiful.

Mary & Jake said...

Wow, J that was a beautiful and moving story. I hope that all is well! Miss you!

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