It began like any other day on the OB floor.  My hair was still wet under my cap from my morning shower at 4:30am.  I was just returning to labor and delivery after making postpartum rounds and performing the daily circumcisions.  The doctors and medical students were all congregated for board rounds.  During board rounds we learned who was working and what was going on with each patient.

As I approached the board, the chief resident grabbed me and directed me to a room adjacent to the board.  The patient in the small bed was a 16-year-old cocaine addict who was having a miscarriage.  I was told that we did not know the gestational age of the infant but that ultrasound showed that the baby was already dead.  My job was to stay with the mother until “the products of conception were passed.”  Everyone else left the room and went back to the board.

It seemed that it all happened in the blink of an eye.  Suddenly an intact amniotic sac was propelled from the mother’s body.  Through the translucent sac, I could see a small infant moving.  It was definitely alive.  Instinct took over.  I grabbed the infant and ran past the board yelling at the others to send someone in to be with the mother.  I sprinted to the NICU and called for help.  A doctor rushed toward me and took the infant from my hands.  She was still moving within the amniotic sac.  The doctor placed her on the warmer and cut open the sac with scissors.  The struggling infant was so tiny.  Her eyes were still sealed.  The doctor reared back in anger and glared at me as he yelled, “Why did you bring that thing in here?  We can’t do anything for it.  It is too young.  Take it back to labor and delivery.”

I was stunned.  I wrapped the struggling infant in a blanket and took her back to labor and delivery.  They were no happier to see me than the NICU doctors had been.  In the back of labor and delivery was a room that was used to store infant warmers.  One of the doctors took me there and told me to place the infant on the warmer with some blow by oxygen and “get on with my day.”  I asked if I could take the infant to its mother and I was told that I was cruel to suggest that a 16-year-old girl should have to suffer by watching “it” die.

I went through my day mechanically, stopping at every chance I had to go back to that room and hold the tiny hand and stroke the little head.  I watched the struggle for life as her chest heaved with each effort to breathe.  Finally after 4 hours it was over and she was still.

I went back to the mother’s chart and wrote a delivery note and then a death note.  My supervisors were not pleased to see those notes in the record.  They validated the birth and death of an infant.  No one wanted to acknowledge these events. There was no happiness associated with them.  There was only pain and loss and sadness.  Minimizing or ignoring the truth did not make it go away.  She was not an “it,” not a “product of conception,” not a nonviable “thing,” and not a “choice.”

It has been over 20 years since I met her.  Her life was brief but it was indelibly etched on my soul and she will always live in my heart.  Even now as I write these words I cry for her. She was a tiny baby girl and when she passed away God saw a sparrow fall.

Brenda Izen is a physician.